Cardiac surgery-associated acute kidney injury

Huijuan Mao, Nevin Katz, Wassawon Ariyanon, Lourdes Blanca-Martos, Zelal Adýbelli, Anna Giuliani, Tommaso H inna Danesi, Jeong C hul Kim, Akash Nayak, Mauro Neri, Grazia M aria Virzi, Alessandra Brocca, Elisa Scalzotto, Loris Salvador, Claudio Ronco

Research output: Contribution to journalArticle

Abstract

Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common and serious postoperative complication of cardiac surgery requiring cardiopulmonary bypass (CPB), and it is the second most common cause of AKI in the intensive care unit. Although the complication has been associated with the use of CPB, the etiology is likely multifactorial and related to intraoperative and early postoperative management including pharmacologic therapy. To date, very little evidence from randomized trials supporting specific interventions to protect from or prevent AKI in broad cardiac surgery populations has been found. The definition of AKI employed by investigators influences not only the incidence of CSA-AKI, but also the identification of risk variables. The advent of novel biomarkers of kidney injury has the potential to facilitate the subclinical diagnosis of CSA-AKI, the assessment of its severity and prognosis, and the early institution of interventions to prevent or reduce kidney damage. Further studies are needed to determine how to optimize cardiac surgical procedures, CPB parameters, and intraoperative and early postoperative blood pressure and renal blood flow to reduce the risk of CSA-AKI. No pharmacologic strategy has demonstrated clear efficacy in the prevention of CSA-AKI; however, some agents, such as the natriuretic peptide nesiritide and the dopamine agonist fenoldopam, have shown promising results in renoprotection. It remains unclear whether CSA-AKI patients can benefit from the early institution of such pharmacologic agents or the early initiation of renal replacement therapy.

Original languageEnglish (US)
Pages (from-to)34-50
Number of pages17
JournalBlood Purification
Volume37
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Acute Kidney Injury
Thoracic Surgery
Cardiopulmonary Bypass
Fenoldopam
Cardiac Surgical Procedures
Kidney
Natriuretic Peptides
Renal Replacement Therapy
Renal Circulation
Brain Natriuretic Peptide
Dopamine Agonists
Intensive Care Units
Biomarkers
Research Personnel
Blood Pressure
Incidence
Wounds and Injuries
Population

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Mao, H., Katz, N., Ariyanon, W., Blanca-Martos, L., Adýbelli, Z., Giuliani, A., ... Ronco, C. (2014). Cardiac surgery-associated acute kidney injury. Blood Purification, 37, 34-50. https://doi.org/10.1159/000361062

Cardiac surgery-associated acute kidney injury. / Mao, Huijuan; Katz, Nevin; Ariyanon, Wassawon; Blanca-Martos, Lourdes; Adýbelli, Zelal; Giuliani, Anna; Danesi, Tommaso H inna; Kim, Jeong C hul; Nayak, Akash; Neri, Mauro; Virzi, Grazia M aria; Brocca, Alessandra; Scalzotto, Elisa; Salvador, Loris; Ronco, Claudio.

In: Blood Purification, Vol. 37, 2014, p. 34-50.

Research output: Contribution to journalArticle

Mao, H, Katz, N, Ariyanon, W, Blanca-Martos, L, Adýbelli, Z, Giuliani, A, Danesi, THI, Kim, JCH, Nayak, A, Neri, M, Virzi, GMA, Brocca, A, Scalzotto, E, Salvador, L & Ronco, C 2014, 'Cardiac surgery-associated acute kidney injury', Blood Purification, vol. 37, pp. 34-50. https://doi.org/10.1159/000361062
Mao H, Katz N, Ariyanon W, Blanca-Martos L, Adýbelli Z, Giuliani A et al. Cardiac surgery-associated acute kidney injury. Blood Purification. 2014;37:34-50. https://doi.org/10.1159/000361062
Mao, Huijuan ; Katz, Nevin ; Ariyanon, Wassawon ; Blanca-Martos, Lourdes ; Adýbelli, Zelal ; Giuliani, Anna ; Danesi, Tommaso H inna ; Kim, Jeong C hul ; Nayak, Akash ; Neri, Mauro ; Virzi, Grazia M aria ; Brocca, Alessandra ; Scalzotto, Elisa ; Salvador, Loris ; Ronco, Claudio. / Cardiac surgery-associated acute kidney injury. In: Blood Purification. 2014 ; Vol. 37. pp. 34-50.
@article{25fad77c981e4f4eb7b6af6ef2cbdf29,
title = "Cardiac surgery-associated acute kidney injury",
abstract = "Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common and serious postoperative complication of cardiac surgery requiring cardiopulmonary bypass (CPB), and it is the second most common cause of AKI in the intensive care unit. Although the complication has been associated with the use of CPB, the etiology is likely multifactorial and related to intraoperative and early postoperative management including pharmacologic therapy. To date, very little evidence from randomized trials supporting specific interventions to protect from or prevent AKI in broad cardiac surgery populations has been found. The definition of AKI employed by investigators influences not only the incidence of CSA-AKI, but also the identification of risk variables. The advent of novel biomarkers of kidney injury has the potential to facilitate the subclinical diagnosis of CSA-AKI, the assessment of its severity and prognosis, and the early institution of interventions to prevent or reduce kidney damage. Further studies are needed to determine how to optimize cardiac surgical procedures, CPB parameters, and intraoperative and early postoperative blood pressure and renal blood flow to reduce the risk of CSA-AKI. No pharmacologic strategy has demonstrated clear efficacy in the prevention of CSA-AKI; however, some agents, such as the natriuretic peptide nesiritide and the dopamine agonist fenoldopam, have shown promising results in renoprotection. It remains unclear whether CSA-AKI patients can benefit from the early institution of such pharmacologic agents or the early initiation of renal replacement therapy.",
author = "Huijuan Mao and Nevin Katz and Wassawon Ariyanon and Lourdes Blanca-Martos and Zelal Ad{\'y}belli and Anna Giuliani and Danesi, {Tommaso H inna} and Kim, {Jeong C hul} and Akash Nayak and Mauro Neri and Virzi, {Grazia M aria} and Alessandra Brocca and Elisa Scalzotto and Loris Salvador and Claudio Ronco",
year = "2014",
doi = "10.1159/000361062",
language = "English (US)",
volume = "37",
pages = "34--50",
journal = "Blood Purification",
issn = "0253-5068",
publisher = "S. Karger AG",

}

TY - JOUR

T1 - Cardiac surgery-associated acute kidney injury

AU - Mao, Huijuan

AU - Katz, Nevin

AU - Ariyanon, Wassawon

AU - Blanca-Martos, Lourdes

AU - Adýbelli, Zelal

AU - Giuliani, Anna

AU - Danesi, Tommaso H inna

AU - Kim, Jeong C hul

AU - Nayak, Akash

AU - Neri, Mauro

AU - Virzi, Grazia M aria

AU - Brocca, Alessandra

AU - Scalzotto, Elisa

AU - Salvador, Loris

AU - Ronco, Claudio

PY - 2014

Y1 - 2014

N2 - Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common and serious postoperative complication of cardiac surgery requiring cardiopulmonary bypass (CPB), and it is the second most common cause of AKI in the intensive care unit. Although the complication has been associated with the use of CPB, the etiology is likely multifactorial and related to intraoperative and early postoperative management including pharmacologic therapy. To date, very little evidence from randomized trials supporting specific interventions to protect from or prevent AKI in broad cardiac surgery populations has been found. The definition of AKI employed by investigators influences not only the incidence of CSA-AKI, but also the identification of risk variables. The advent of novel biomarkers of kidney injury has the potential to facilitate the subclinical diagnosis of CSA-AKI, the assessment of its severity and prognosis, and the early institution of interventions to prevent or reduce kidney damage. Further studies are needed to determine how to optimize cardiac surgical procedures, CPB parameters, and intraoperative and early postoperative blood pressure and renal blood flow to reduce the risk of CSA-AKI. No pharmacologic strategy has demonstrated clear efficacy in the prevention of CSA-AKI; however, some agents, such as the natriuretic peptide nesiritide and the dopamine agonist fenoldopam, have shown promising results in renoprotection. It remains unclear whether CSA-AKI patients can benefit from the early institution of such pharmacologic agents or the early initiation of renal replacement therapy.

AB - Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common and serious postoperative complication of cardiac surgery requiring cardiopulmonary bypass (CPB), and it is the second most common cause of AKI in the intensive care unit. Although the complication has been associated with the use of CPB, the etiology is likely multifactorial and related to intraoperative and early postoperative management including pharmacologic therapy. To date, very little evidence from randomized trials supporting specific interventions to protect from or prevent AKI in broad cardiac surgery populations has been found. The definition of AKI employed by investigators influences not only the incidence of CSA-AKI, but also the identification of risk variables. The advent of novel biomarkers of kidney injury has the potential to facilitate the subclinical diagnosis of CSA-AKI, the assessment of its severity and prognosis, and the early institution of interventions to prevent or reduce kidney damage. Further studies are needed to determine how to optimize cardiac surgical procedures, CPB parameters, and intraoperative and early postoperative blood pressure and renal blood flow to reduce the risk of CSA-AKI. No pharmacologic strategy has demonstrated clear efficacy in the prevention of CSA-AKI; however, some agents, such as the natriuretic peptide nesiritide and the dopamine agonist fenoldopam, have shown promising results in renoprotection. It remains unclear whether CSA-AKI patients can benefit from the early institution of such pharmacologic agents or the early initiation of renal replacement therapy.

UR - http://www.scopus.com/inward/record.url?scp=84928954464&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84928954464&partnerID=8YFLogxK

U2 - 10.1159/000361062

DO - 10.1159/000361062

M3 - Article

C2 - 25196567

AN - SCOPUS:84928954464

VL - 37

SP - 34

EP - 50

JO - Blood Purification

JF - Blood Purification

SN - 0253-5068

ER -