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Review
. 2015 Mar 6;10(3):500-14.
doi: 10.2215/CJN.07830814. Epub 2014 Nov 6.

AKI associated with cardiac surgery

Robert H Thiele  1 , James M Isbell  2 , Mitchell H Rosner  3
Affiliations
Review

AKI associated with cardiac surgery

Robert H Thiele et al. Clin J Am Soc Nephrol. .

Abstract

Approximately 18% of patients undergoing cardiac surgery experience AKI (on the basis of modern standardized definitions of AKI), and approximately 2%-6% will require hemodialysis. The development of AKI after cardiac surgery portends poor short- and long-term prognoses, with those developing RIFLE failure or AKI Network stage III having an almost 2-fold increase in the risk of death. AKI is caused by a variety of factors, including nephrotoxins, hypoxia, mechanical trauma, inflammation, cardiopulmonary bypass, and hemodynamic instability, and it may be affected by the clinician's choice of fluids and vasoactive agents as well as the transfusion strategy used. The risk of AKI may be ameliorated by avoidance of nephrotoxins, achievement of adequate glucose control preoperatively, and use of goal-directed therapy hemodynamic strategies. Remote ischemic preconditioning is an exciting future strategy, but more work is needed before widespread implementation. Unfortunately, there are no pharmacologic agents known to reduce the risk of AKI or treat established AKI.

Keywords: acute renal failure; cardiovascular; epidemiology and outcomes.

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References

    1. Kiers HD, van den Boogaard M, Schoenmakers MC, van der Hoeven JG, van Swieten HA, Heemskerk S, Pickkers P: Comparison and clinical suitability of eight prediction models for cardiac surgery-related acute kidney injury. Nephrol Dial Transplant 28: 345–351, 2013 - PubMed
    1. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P, Acute Dialysis Quality Initiative workgroup : Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: The Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 8: R204–R212, 2004 - PMC - PubMed
    1. Lameire N, Van Biesen W, Vanholder R: Acute renal failure. Lancet 365: 417–430, 2005 - PubMed
    1. Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, Levin A, Acute Kidney Injury Network : Acute Kidney Injury Network: Report of an initiative to improve outcomes in acute kidney injury. Crit Care 11: R31, 2007 - PMC - PubMed
    1. Mariscalco G, Cottini M, Dominici C, Banach M, Piffaretti G, Borsani P, Bruno VD, Corazzari C, Gherli R, Beghi C: The effect of timing of cardiac catheterization on acute kidney injury after cardiac surgery is influenced by the type of operation. Int J Cardiol 173: 46–54, 2014 - PubMed

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