Document Type

Article

Publication Date

4-20-2026

Abstract

ABSTRACT

1.Structured summary:

Background: Cardiopulmonary bypass (CPB) is associated with significant hemodilution, inflammatory activation, and alterations in renal perfusion, all of which may contribute to postoperative acute kidney injury (AKI). Albumin is frequently used as a component of CPB pump prime due to its oncotic properties and potential to mitigate fluid shifts and support intravascular volume. However, the extent to which albumin-containing priming solutions influence postoperative renal outcomes remains unclear.

Objective: This scoping review aimed to map the available literature examining the use of albumin in CPB pump prime and its reported effects on renal function and the incidence of acute kidney injury in patients undergoing cardiac surgery with cardiopulmonary bypass.

Eligibility Criteria: Studies were included if they evaluated the use of albumin as a component of the CPB pump prime and reported at least one renal-related outcome, including acute kidney injury, serum creatinine, urine output, renal biomarkers, or need for renal replacement therapy. Randomized controlled trials, observational studies, and experimental studies were considered for inclusion.

Results: A total of 73 records were identified through database searching, of which 56 titles and abstracts were screened after removal of duplicates. Following full-text review, 16 studies met the inclusion criteria. Included studies demonstrated variability in study design, patient populations, albumin concentration within the pump prime, comparator fluids, and definitions of renal outcomes. Findings regarding the association between albumin-containing priming solutions and postoperative renal outcomes were inconsistent across the literature.

Conclusion: The current evidence regarding albumin use in CPB pump prime and renal outcomes is heterogeneous and does not consistently demonstrate a reduction in acute kidney injury or improvement in postoperative renal function. Further research using standardized renal outcome definitions and clearly defined priming protocols is needed to determine whether albumin provides clinically meaningful renal protection during cardiopulmonary bypass.

Keywords: Cardiopulmonary bypass; albumin; pump prime; acute kidney injury; renal function; cardiac surgery

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