Intraoperative 20% albumin infusion and acute kidney injury in on-pump cardiac surgery: a focus on preoperative albumin levels

BACKGROUND: Albumin is widely used for volume replacement therapy during cardiopulmonary bypass (CPB) including priming fluid, despite significant controversy over its benefits. This study aimed to examine how 20% exogenous albumin affects kidney function in patients with varying preoperative albumin levels. METHODS: = 14,764). Multivariate logistic regression, propensity score matching (PSM), and an inverse probability-weighting (IPW) model were applied to evaluated the impact of 20% albumin infusion on cardiac surgery-associated acute kidney injury (CSA-AKI). RESULTS: < 0.001 for IPW model). However, there was no significant association with Stage 2 and 3 CSA-AKI both for multivariable logistic regression and PSM. CONCLUSIONS: This analysis highlights that 20% albumin infusion during on-pump cardiac surgery may increase the risk of all stages CSA-AKI in patients with preoperative albumin above 40 g/L.