Perioperative Acute Kidney Injury: Risk Factors and Predictive Strategies

Abstract

Acute kidney injury (AKI) is a common complication in surgical patients and is associated with increases in mortality, an increased risk for chronic kidney disease and hemodialysis after discharge, and increased cost. Better understanding of the risk factors that contribute to perioperative AKI has led to improved AKI prediction and will eventually lead to improved prevention of AKI, mitigation of injury when AKI occurs, and enhanced recovery in patients who sustain AKI. The development of advanced clinical prediction scores for AKI, new imaging techniques, and novel biomarkers for early detection of AKI provides new tools toward these ends.

Keywords: AKI; Acute kidney injury; BOLD MRI; Biomarkers; CEUS; DWI MRI; Prediction scores.

Conflict of interest statement

Conflicts of Interest: No authors report conflicts of interest.

Copyright © 2016 Elsevier Inc. All rights reserved.

Figures

Figure 1. A Clinical Pathway for Evaluating and Managing Acute Kidney Injury

From Bihorac, A. Critical Connections Guiding AKI Prevention Using Biomarkers. Critical Connections. April 2, 2015.

Figure 2. AKI Management Options

Kellum, John A. Acute Kidney Injury and AKI Biomarkers in the ICU. Southeaster Critical Care Summit, May 5, 2016. Adapted from Kidney Disease: Improving GlobalOutcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney inter., Suppl. 2012; 2: 1–138.