SYSTEMATIC REVIEW article
Front. Med.
Sec. Nephrology
Risk Factors for Acute Kidney Injury After Coronary Artery Bypass Graft Surgery: A Systematic Review and Meta-Analysis
Provisionally accepted
- 1Changchun University of Chinese Medicine, Changchun, China
- 2Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
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Background: Acute kidney injury (AKI) is one of the common and severe complications following coronary artery bypass graft (CABG) surgery, significantly increasing patient mortality, complication rates, and length of hospital stay. Although numerous studies have explored risk factors for postoperative AKI after CABG, results remain inconsistent. This systematic review and meta-analysis aim to synthesize existing evidence to identify the primary risk factors for AKI following CABG. Methods: Systematically searched PubMed, Embase, Web of Science, and Cochrane Library databases from their inception to September 20, 2025. Observational studies reporting risk factors for postoperative AKI following CABG were included. Two researchers independently performed literature screening, data extraction, and quality assessment. Random-effects models were used to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). The I² statistic was employed for heterogeneity analysis, and funnel plots and Egger's test were used to assess publication bias. Results: A total of 17 research papers involving 33,809 patients were included. The results of the meta-analysis suggest that older age [OR = 1.05, 95% CI (1.03, 1.08)], prolonged cardiopulmonary bypass [OR = 1.14, 95% CI (1.06, 1.22)], diabetes [OR = 1.29, 95% CI (1.15, 1.45)], intra-aortic balloon pump [OR = 3.19, 95% CI (1.74, 5.85)], transfusion of red blood cells [OR = 1.73, 95% CI (1.25, 2.38)] may be associated with the occurrence of AKI after CABG. Conclusion: Meta-analysis results indicate that older age, prolonged cardiopulmonary bypass duration, diabetes, intra-aortic balloon pump use, and red blood cell transfusion are all significant risk factors for AKI following CABG. Among these, prolonged cardiopulmonary bypass duration and intra-aortic balloon pump use exert a particularly pronounced effect on AKI occurrence.
Keywords: Acute Kidney Injury, Coronary artery bypass graft, Meta-analysis, Risk factors, Systematic review
Received: 11 Oct 2025; Accepted: 02 Feb 2026.
Copyright: © 2026 Chu, Li, Cao, Xu, Yang and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lihua Yang
Chun Ma
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