Preoperative natremia and AKI after cardiac surgery: a multicenter prospective cohort study
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Authors
Lopez P.M.
Mora J.M.
Candela A.
Tamayo E.
Nagore D.
Nunez J.
Echarri G.
Callejas R.
Vives,M.
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2025
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Conference Proceedings
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Objective: Whether preoperative natremia levels may play a role in the development of acute kidney injury (AKI) after cardiac surgery is uncertain. We conducted a cohort study to evaluate the influence of preoperative natremia on AKI in high-risk patients undergoing cardiac surgery. Design and method: This multicenter prospective cohort study involved 14 British and Spanish hospitals, each under local ethics committee approval. The study population comprised all consecutive patients aged 18 years or older, with a Cleveland score higher than 4, undergoing cardiac surgery from July to December 2017. The resultant 249 consecutive patients were classified according to tertiles of preoperative natremia levels (141 mmol/L). AKIN criteria were used for AKI definition. Result(s) and Conclusion(s): Multivariable logistic regression modeling were used to determine the adjusted association between preoperative natremia levels and AKI. Multivariate analysis confirmed that sodium levels below 139 mmol/L were associated with a two-fold increased risk of developing AKI. 19% of patients with serum sodium levels below 139 mmol/L required renal replacement therapy, while 13% of patients with serum sodium above 141 mmol/L also required renal replacement therapy. In contrast, the group with sodium levels between 139 and 141 mmol/L had the lowest number of patients with severe AKI. Patients with low levels of preoperative natremia were associated with an increased risk of AKI after CS, compared to normal levels. Copyright © 2025
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Journal of cardiothoracic and vascular anesthesia
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