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. 2012 Jul;28(3):248-55.
doi: 10.4103/0970-1591.102691.

Peri-operative renal protection: The strategies revisited

Sukhminder Jit Singh Bajwa  1 , Veenita Sharma
Affiliations

Peri-operative renal protection: The strategies revisited

Sukhminder Jit Singh Bajwa et al. Indian J Urol. 2012 Jul.

Abstract

Postoperative acute renal failure (ARF) is a serious complication which can result in a prolonged hospital stay and a high mortality and morbidity. Underlying renal disease, cardiac diseases, nephrotoxin exposure and renal hypoperfusion are the possible predisposing risk factors which can create a high probability for the development of ARF. The incidence of ARF is highest after major vascular, cardiac and high-risk thoraco-abdominal surgery. Among the various renal protection strategies, adequate peri-operative volume expansion and avoidance of hypovolemia is the most accepted and practiced strategy. Numerous bio-markers of renal injury are used to estimate the presence and extent of renal insult and various new are currently under trial. Traditional pharmacological interventions like dopamine, diuretics and calcium antagonists are not currently the first line of reno-protective agents. The new non-pharmacological and pharmacological methods may improve outcome in renal transplantation, contrast-induced nephropathy and in various other settings of ARF. The current review is an attempt to refresh the knowledge and put forth the various renal protection strategies during the peri-operative period.

Keywords: Acute renal failure; acute tubular necrosis; nephrotoxins; peri-operative renal protection strategies; renal protection.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Prolonged ischemia
See this image and copyright information in PMC

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