Perioperative Acute Kidney Injury

Authors

Sam D Gumbert
Felix Kork
Maisie L Jackson
Naveen Vanga
Semhar J Ghebremichael
Christy Y Wang
Holger K Eltzschig

Publication Date

1-1-2020

Journal

Anesthesiology

DOI

10.1097/ALN.0000000000002968

PMID

31687986

PMCID

PMC10924686

PubMedCentral® Posted Date

3-10-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Acute Kidney Injury, Humans, Perioperative Care, acute kidney injury, renal biomarkers, Kidney Disease Improving Global Outcomes, remote ischemic preconditioning, renal replacement therapy, sepsis, creatinine, neutrophil gelatinase-associated lipocalin, kidney injury molecule-1, adenosine

Abstract

Perioperative organ injury is among the leading causes of morbidity and mortality of surgical patients. Among different types of perioperative organ injury, acute kidney injury occurs particularly frequently and has an exceptionally detrimental effect on surgical outcomes. Currently, acute kidney injury is most commonly diagnosed by assessing increases in serum creatinine concentration or decreased urine output. Recently, novel biomarkers have become a focus of translational research for improving timely detection and prognosis for acute kidney injury. However, specificity and timing of biomarker release continue to present challenges to their integration into existing diagnostic regimens. Despite many clinical trials using various pharmacologic or nonpharmacologic interventions, reliable means to prevent or reverse acute kidney injury are still lacking. Nevertheless, several recent randomized multicenter trials provide new insights into renal replacement strategies, composition of intravenous fluid replacement, goal-directed fluid therapy, or remote ischemic preconditioning in their impact on perioperative acute kidney injury. This review provides an update on the latest progress toward the understanding of disease mechanism, diagnosis, and managing perioperative acute kidney injury, as well as highlights areas of ongoing research efforts for preventing and treating acute kidney injury in surgical patients.

Comments

Associated Data