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

M Vives, A Hernandez, F Parramon, N Estanyol, B Pardina, A Muñoz, P Alvarez, C Hernandez, M Vives, A Hernandez, F Parramon, N Estanyol, B Pardina, A Muñoz, P Alvarez, C Hernandez

Abstract

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: acute kidney injury; acute renal failure; cardiac surgery; prevention; therapy.

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Summary of the different and complex pathophysiologic mechanisms.

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