Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan 1;142(1):180-201.
doi: 10.1097/ALN.0000000000005215.

Perioperative Acute Kidney Injury: Diagnosis, Prediction, Prevention, and Treatment

Nicholas J Douville  1 , Michael Mathis  2 , Sachin Kheterpal  3 , Michael Heung  4 , Jennifer Schaub  4 , Abhijit Naik  4 , Matthias Kretzler  5
Affiliations

Perioperative Acute Kidney Injury: Diagnosis, Prediction, Prevention, and Treatment

Nicholas J Douville et al. Anesthesiology. .

Abstract

In this review, the authors define acute kidney injury in the perioperative setting, describe the epidemiologic burden, discuss procedure-specific risk factors, detail principles of management, and highlight areas of ongoing controversy and research.

PubMed Disclaimer

Conflict of interest statement

Dr. Mathis received funding paid to the University of Michigan (Ann Arbor, Michigan) from Chiesi USA (Cary, North Carolina) for work unrelated to the scope of the research presented in this manuscript. Dr. Heung has received payments from legal firms for expert testimony, CardioSounds LLC Ann Arbor, Michigan) as a paid consultant, grant funding from Astute Medical Inc. (Canton, Ohio), grant funding to the University of Michigan from Spectral Diagnostics (Toronto, Ontario), and Wolters-Kluwer Inc. for consulting fees as a senior editor for Lexicomp drug dosing guidelines. Dr. Schaub has received funding through the RPC2 consortium (Astra Zeneca [Cambridge, United Kingdom], Genetech [San Francisco, California], NovoNordisk [Bagsvaerd, Denmark], Eli Lilly [Indianapolis, Indiana]). Dr. Kretzler has received funding from the Chan Zuckerberg Initiative, Janssen (Beerse, Belgium; as an employee of the University of Michigan), Eli Lilly, Gilead (Foster City, California), Boehringer-Ingelheim (Ridgefield, Connecticut), Moderna (Cambridge, Massachusetts), the European Union Innovative Medicine Initiative, Certa (Saratoga, California), Chinook Tulsa, Oklahoma), Angion (San Francisco, California), RenalytixAI (New York, New York), Travere (San Diego, California), Regeneron, IONIS (Carlsbad, California), Maze Therapeutics (San Francisco, California), Roche-Genentech, Sanofi (Paris, France), and Dimerix (Victoria, Australia; as an employee of the University of Michigan). Additionally, Dr. Kretzler holds a patent, PCT/EP2014/073413: Biomarkers and Methods for Progression Prediction for Chronic Kidney Disease. The other authors declare no competing interests.

Figures

Fig. 1.
Fig. 1.
Pathophysiology of perioperative acute kidney injury. ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; NSAID, Nonsteroidal anti-inflammatory drug.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. O’Connor ME, Kirwan CJ, Pearse RM, Prowle JR: Incidence and associations of acute kidney injury after major abdominal surgery. Intensive Care Med 2016; 42:521–30 - PubMed
    1. Prowle JR, Forni LG, Bell M, et al. : Postoperative acute kidney injury in adult non-cardiac surgery: Joint consensus report of the Acute Disease Quality Initiative and PeriOperative Quality Initiative. Nat Rev Nephrol 2021; 17:605–18 - PMC - PubMed
    1. Hobson C, Lysak N, Huber M, Scali S, Bihorac A: Epidemiology, outcomes, and management of acute kidney injury in the vascular surgery patient. J Vasc Surg 2018; 68:916–28 - PMC - PubMed
    1. Tian J, Barrantes F, Amoateng-Adjepong Y, Manthous CA: Rapid reversal of acute kidney injury and hospital outcomes: A retrospective cohort study. Am J Kidney Dis 2009; 53:974–81 - PubMed
    1. Kork F, Balzer F, Spies CD, et al. : Minor postoperative increases of creatinine are associated with higher mortality and longer hospital length of stay in surgical patients. Anesthesiology 2015; 123:1301–11 - PMC - PubMed