Trial reportActa anaesthesiologica Scandinavica2026
Dextran vs. Crystalloid Priming Solution in Cardiac Surgery: A Randomized Trial on Acute Kidney Injury.
Trial report in Acta anaesthesiologica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04293744 (Acute Kidney Injury After Cardiac Surgery; A Prospective Randomized Study of Dextran Based and Crystalloid Priming Solutions), which is not on this map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Acute Kidney Injury After Cardiac Surgery; A Prospective Randomized Study of Dextran Based and Crystalloid Priming Solutions (PRIMING II Trial)
Who cites it
2 citing papers in PubMed.
- Dextran vs. Crystalloid Priming Solution in Cardiac Surgery: A Randomized Trial on Acute Kidney Injury.Acta anaesthesiologica Scandinavica · 2026Trial
- Haematocrit During Cardiopulmonary Bypass and Risk for Acute Kidney Injury: An Observational Single-Centre Study.Interdisciplinary cardiovascular and thoracic surgery · 2026Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
backgroundAcute kidney injury (AKI) is a frequent complication following cardiac surgery involving cardiopulmonary bypass (CPB). This is partly attributable to crystalloid-based priming solutions causing both hemolysis and loss of oncotic pressure with tissue edema. While colloids like albumin and starches have not shown clear benefits, pilot studies using dextran-based priming reported improved oncotic pressure, reduced hemolysis, and lower levels of a renal injury marker, suggesting potential renal protective effects.
objectiveWe hypothesized that a dextran-based priming solution can reduce the incidence of postoperative AKI in high-risk patients undergoing cardiac surgery with CPB.
methodsIn this randomized, controlled, double-blinded, multicenter trial, adult patients with a calculated postoperative AKI risk of ≥ 50% were assigned to receive either a dextran or a crystalloid-based CPB priming solution. The primary outcome was the incidence of AKI within 96 h postoperatively. Secondary outcomes included perioperative hemolysis, net fluid balance, and the need for postoperative renal replacement therapy.
resultsThe trial was terminated early due to slow enrolment, with 101 of the planned 366 patients recruited. A total of 92 patients were included in the final analysis (43 in the dextran group, 49 in the control group). Postoperative AKI occurred in 81% and 53% of patients in the dextran and control groups, respectively (risk ratio 1.53, 95% confidence interval 1.15-2.06, p = 0.004). The dextran group demonstrated lower intraoperative hemolysis and a more favorable net fluid balance. Postoperative renal replacement therapy was required in 7% of the dextran group and 4% of the control group (p = 0.66). No significant differences in adverse events were observed between the groups.
conclusionIn high-risk patients undergoing cardiac surgery with CPB, the use of a dextran-based priming solution was associated with a significantly increased risk of postoperative AKI. EDITORIAL COMMENT: This randomized multicenter trial compared dextran to a crystalloid-based priming solution during cardiopulmonary bypass in participants with elevated risk of acute kidney injury. While the trial had to be terminated due to slow enrolment after about a third of planned cases were included, acute kidney injury was significantly more common in the dextran group, contrary to the primary hypothesis of the study. The study highlights the complexity and logistical challenges of conducting randomized treatment protocols for cardiopulmonary bypass, but at the same time highlights the importance of conducting such studies.
trial registrationClinicalTrials.gov identifier: NCT04293744.
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