Acute kidney injury after cardiac surgery: prevalence, impact and management challenges

Abstract

M Vives,1 A Hernandez,2 F Parramon,3 N Estanyol,3 B Pardina,3 A Muñoz,3 P Alvarez,4 C Hernandez31Department of Anesthesiology & Critical Care, Clinical Research Lead, Hospital Universitari Dr Josep Trueta, Universitat de Girona, Institut d´Investigació Biomédica de Girona (IDIBGI), Girona, Spain; 2Department of Anesthesia & Critical Care, Grupo Policlinica, Ibiza, Spain; 3Department of Anesthesiology & Critical Care Chief, Hospital Universitari Dr Josep Trueta, Universitat de Girona, Girona, Spain; 4Department of Cardiac Surgery, Hospital Universitari Dr Josep Trueta, Universitat de Girona, Girona, SpainAbstract: Acute kidney injury (AKI) is a major medical problem that is of particular concern after cardiac surgery. Perioperative AKI is independently associated with an increase in short-term morbidity, costs of treatment, and long-term mortality. In this review, we explore the definition of cardiac surgery-associated acute kidney injury (CSA-AKI) and identify diverse mechanisms and risk factors contributing to the renal insult. Current theories of the pathophysiology of CSA-AKI and description of its clinical course will be addressed in this review. Data on the most promising renal protective strategies in cardiac surgery, from well-designed studies, will be scrutinized. Furthermore, diagnostic tools such as novel biomarkers of AKI and their potential utility will be discussed.Keywords: cardiac surgery, acute renal failure, acute kidney injury, prevention, therapy

Keywords

• Cardiac surgery
• Acute Renal Failure
• Acute Kidney Injury
• Prevention
• Therapy