Major cardiovascular surgery, particularly with cardiopulmonary bypass (CPB), induces significant changes in protein metabolism. Patients developing postoperative acute kidney injury (AKI) exhibited specific metabolic signatures.

These findings may be critical for designing interventions to minimize organ dysfunction, including AKI, and improve outcomes in major cardiovascular surgery.

A prospective observational study included 53 patients undergoing major cardiovascular surgery in 3 groups: cardiac surgery with cardiopulmonary bypass (CPB n = 33), without CPB (n = 10), and major vascular surgery (n = 10).

For each patient, peripheral blood samples were collected pre-surgery, and at 6 h and 24 h post-surgery.

Untargeted metabolomics using mass spectrometry quantified 8668 metabolic features in serum samples.

Linear mixed-effect models (adjusted for age, sex, and body mass index) and pathway analyses were performed.

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