Cardiac surgery-associated acute kidney injury

Huijuan Mao, Nevin Katz, Wassawon Ariyanon, Lourdes Blanca-Martos, Zelal Adýbelli, Anna Giuliani, Tommaso Hinna Danesi, Jeong Chul Kim, Akash Nayak, Mauro Neri, Grazia Maria 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)178-199
Number of pages22
JournalCardioRenal Medicine
Volume3
Issue number3
DOIs
StatePublished - 2013

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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

Keywords

  • Acute kidney injury
  • Cardiac surgical procedures
  • Cardiopulmonary bypass
  • Renal replacement therapy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Urology

Cite this

Mao, H., Katz, N., Ariyanon, W., Blanca-Martos, L., Adýbelli, Z., Giuliani, A., ... Ronco, C. (2013). Cardiac surgery-associated acute kidney injury. CardioRenal Medicine, 3(3), 178-199. https://doi.org/10.1159/000353134

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

In: CardioRenal Medicine, Vol. 3, No. 3, 2013, p. 178-199.

Research output: Contribution to journalArticle

Mao, H, Katz, N, Ariyanon, W, Blanca-Martos, L, Adýbelli, Z, Giuliani, A, Danesi, TH, Kim, JC, Nayak, A, Neri, M, Virzi, GM, Brocca, A, Scalzotto, E, Salvador, L & Ronco, C 2013, 'Cardiac surgery-associated acute kidney injury', CardioRenal Medicine, vol. 3, no. 3, pp. 178-199. https://doi.org/10.1159/000353134
Mao H, Katz N, Ariyanon W, Blanca-Martos L, Adýbelli Z, Giuliani A et al. Cardiac surgery-associated acute kidney injury. CardioRenal Medicine. 2013;3(3):178-199. https://doi.org/10.1159/000353134
Mao, Huijuan ; Katz, Nevin ; Ariyanon, Wassawon ; Blanca-Martos, Lourdes ; Adýbelli, Zelal ; Giuliani, Anna ; Danesi, Tommaso Hinna ; Kim, Jeong Chul ; Nayak, Akash ; Neri, Mauro ; Virzi, Grazia Maria ; Brocca, Alessandra ; Scalzotto, Elisa ; Salvador, Loris ; Ronco, Claudio. / Cardiac surgery-associated acute kidney injury. In: CardioRenal Medicine. 2013 ; Vol. 3, No. 3. pp. 178-199.
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