Prevention of Acute Kidney Injury

Mira Küllmar; Alexander Zarbock; Daniel T Engelman; Subhasis Chatterjee; Nana-Maria Wagner

doi:10.1016/j.ccc.2020.07.002

Prevention of Acute Kidney Injury

Crit Care Clin. 2020 Oct;36(4):691-704. doi: 10.1016/j.ccc.2020.07.002. Epub 2020 Aug 13.

Authors

Mira Küllmar¹, Alexander Zarbock², Daniel T Engelman³, Subhasis Chatterjee⁴, Nana-Maria Wagner¹

Affiliations

¹ Department of Anesthesiology, Intensive Care and Pain Medicine, University of Münster, Albert-Schweitzer-Campus 1, Building A1, Münster 48149, Germany.
² Department of Anesthesiology, Intensive Care and Pain Medicine, University of Münster, Albert-Schweitzer-Campus 1, Building A1, Münster 48149, Germany. Electronic address: zarbock@uni-muenster.de.
³ Heart and Vascular Program, Baystate Health and University of Massachusetts Medical School-Baystate, 759 Chestnut Street, Springfield, MA 01199, USA.
⁴ Department of Surgery, Baylor College of Medicine, One Baylor Plaza, MS: BCM 390, Houston, TX 77030, USA; Division of Cardiovascular Surgery, Texas Heart Institute, Houston, TX, USA.

PMID: 32892822
DOI: 10.1016/j.ccc.2020.07.002

Abstract

Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common complication after cardiac surgery and associated with a worse outcome. The pathogenesis of CSA-AKI is complex and multifactorial. Therapeutic options for severe CSA-AKI are limited to renal replacement therapy constituting a supportive measure. Therefore, risk identification, prevention, and early diagnosis are of utmost importance to improve patient outcomes. This review aims to provide an overview of the diagnosis, pathophysiologic mechanisms, and risk factors of CSA-AKI and delineates the strategies for AKI prevention available to improve patient outcomes after cardiac surgery.

Keywords: Acute kidney injury (AKI); Cardiac surgery; KDIGO bundles; Prevention of acute kidney injury (AKI); Renal biomarkers.

Publication types

Review

MeSH terms

Acute Kidney Injury*
Cardiac Surgical Procedures*
Humans
Postoperative Complications
Renal Replacement Therapy
Risk Factors