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. 2021 Nov 14;10(22):5285.
doi: 10.3390/jcm10225285.

Cardiac Surgery Associated AKI Prevention Strategies and Medical Treatment for CSA-AKI

Marlies Ostermann  1 , Gudrun Kunst  2   3 , Eleanor Baker  1 , Kittisak Weerapolchai  4   5 , Nuttha Lumlertgul  1   6   7
Affiliations

Cardiac Surgery Associated AKI Prevention Strategies and Medical Treatment for CSA-AKI

Marlies Ostermann et al. J Clin Med. .

Abstract

Acute kidney injury (AKI) is common after cardiac surgery. To date, there are no specific pharmacological therapies. In this review, we summarise the existing evidence for prevention and management of cardiac surgery-associated AKI and outline areas for future research. Preoperatively, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers should be withheld and nephrotoxins should be avoided to reduce the risk. Intraoperative strategies include goal-directed therapy with individualised blood pressure management and administration of balanced fluids, the use of circuits with biocompatible coatings, application of minimally invasive extracorporeal circulation, and lung protective ventilation. Postoperative management should be in accordance with current KDIGO AKI recommendations.

Keywords: acute kidney injury (AKI); cardiac surgery; cardiac surgery associated AKI; cardiovascular; management; prevention; renal.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Perioperative strategies to prevent AKI after cardiac surgery.
See this image and copyright information in PMC

References

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