Lactate as a Predictive Biomarker and Therapeutic Target in Cardiopulmonary Bypass-Associated Acute Kidney Injury: A Translational Study

This study evaluates the clinical predictive value of lactate and explores its mechanism involving protein lactylation. Machine learning algorithms applied to multicenter intensive care databases identified preoperative lactate as a dominant predictor of CPB-AKI risk.

To validate these predictions biologically, in vivo rat CPB and in vitro cellular models were utilized. Experimental results demonstrated that CPB induces glycolytic reprogramming, lactate accumulation, and elevated global pan-lysine lactylation. Inhibiting lactate dehydrogenase A (LDHA)-mediated lactate production was associated with decreased protein lactylation, lower oxidative stress, and reduced local tissue inflammation, thereby mitigating renal injury.