Cardiac surgery‑associated acute kidney injury.
Loading...
Date
2016-10
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Cardiac surgery‑associated acute kidney injury (CSA‑AKI) is a well‑recognized complication resulting with the
higher morbid‑mortality after cardiac surgery. In its most severe form, it increases the odds ratio of operative
mortality 3–8‑fold, length of stay in the Intensive Care Unit and hospital, and costs of care. Early diagnosis is
critical for an optimal treatment of this complication. Just as the identification and correction of preoperative
risk factors, the use of prophylactic measures during and after surgery to optimize renal function is essential
to improve postoperative morbidity and mortality of these patients. Cardiopulmonary bypass produces an
increased in tubular damage markers. Their measurement may be the most sensitive means of early detection
of AKI because serum creatinine changes occur 48 h to 7 days after the original insult. Tissue inhibitor of
metalloproteinase‑2 and insulin‑like growth factor‑binding protein 7 are most promising as an early diagnostic
tool. However, the ideal noninvasive, specific, sensitive, reproducible biomarker for the detection of AKI within
24 h is still not found. This article provides a review of the different perspectives of the CSA‑AKI, including
pathogenesis, risk factors, diagnosis, biomarkers, classification, postoperative management, and treatment.
We searched the electronic databases, MEDLINE, PubMed, EMBASE using search terms relevant including
pathogenesis, risk factors, diagnosis, biomarkers, classification, postoperative management, and treatment,
in order to provide an exhaustive review of the different perspectives of the CSA-AKI.
Description
Keywords
Acute kidney injury, Cardiac surgery, Cardiopulmonary bypass
Citation
Ortega‑Loubon Christian, Fernández‑Molina Manuel, Carrascal‑Hinojal Yolanda, Fulquet‑Carreras Enrique. Cardiac surgery‑associated acute kidney injury. Annals of Cardiac Anaesthesia. 2016 Oct; 19(4): 687-698.