Key result
Low preoperative serum albumin (< 4.0 gm/dl) significantly increased the risk of postoperative acute kidney injury compared to normal levels in patients undergoing off-pump coronary artery bypass surgery (OR 1.815).
Why the study?
Low preoperative serum albumin is linked to poor outcomes after OPCAB, prompting this assessment of the relationship between preoperative serum albumin levels and early postoperative renal injury.
Does preoperative serum albumin ≥ 4.0 gm/dl prevent postoperative acute kidney injury in adult patients undergoing off-pump coronary artery bypass surgery?
Cross-Sectional (n=160)
No
Does preoperative serum albumin ≥ 4.0 gm/dl prevent postoperative acute kidney injury in adult patients undergoing off-pump coronary artery bypass surgery?
Preoperative serum albumin levels below 4.0 gm/dl are associated with a significantly higher risk of early postoperative acute kidney injury in patients undergoing off-pump coronary artery bypass surgery.
Should not yet change preoperative albumin targets before OPCAB; leaves open causality and whether correction reduces AKI.
Background: Serum albumin, a vital plasma protein, helps maintain intravascular colloidal osmotic pressure, cardiac output, and renal function. Low preoperative serum albumin is linked to poor outcomes, including acute kidney injury (AKI), after off-pump coronary artery bypass (OPCAB) surgery. This study aimed to assess the relationship between preoperative serum albumin levels and early postoperative renal injury. Methods: This prospective comparative cross-sectional study was conducted from August 2019 to February 2021 at the National Heart Foundation Hospital & Research Institute, Bangladesh. It included 160 adult patients with normal preoperative renal function undergoing OPCAB. Patients were divided into two groups: Group A (serum albumin ≥ 4.0 gm/dl) and Group B (serum albumin Results: Preoperative serum albumin was significantly different between groups (Group A: 4.21 ± 0.05 gm/dl, Group B: 3.69 ± 0.04 gm/dl, p = 0.028). Group B had a higher incidence of hypertension (71.25% vs. 51.25%, p st and 3rd postoperative days were higher in Group B (p th day. Postoperative AKI occurred in 18.75% of Group A and 36.25% of Group B. Multivariate regression indicated that low preoperative serum albumin is an independent risk factor for postoperative AKI (p = 0.012, OR = 1.815, CI: 0.675 - 1.162). Conclusion: Preoperative serum albumin level is a valuable predictor of postoperative renal function. Ensuring high normal serum albumin levels before surgery can help minimize the risk of postoperative AKI.
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Salahuddin et al. (2024) conducted a cross-sectional in Off-pump coronary artery bypass (OPCAB) surgery (n=160). Low preoperative serum albumin (< 4.0 gm/dl) vs. Normal preoperative serum albumin (≥ 4.0 gm/dl) was evaluated on Postoperative Acute Kidney Injury (AKI) within 48 hours (OR 1.815, 95% CI 0.675 - 1.162, p=0.012). Low preoperative serum albumin (< 4.0 gm/dl) significantly increased the risk of postoperative acute kidney injury compared to normal levels in patients undergoing off-pump coronary artery bypass surgery (OR 1.815).
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