Prevention and treatment of acute kidney injury in patients undergoing cardiac surgery: A systematic review

Meyeon Park, Steven G. Coca, Sagar U. Nigwekar, Amit X. Garg, Susan Garwood, Chirag Parikh

Research output: Contribution to journalReview article

Abstract

Background: Acute kidney injury (AKI) is common in patients undergoing cardiac surgery and is associated with a high rate of death, long-term sequelae and healthcare costs. We conducted a systematic review of randomized controlled trials for strategies to prevent or treat AKI in cardiac surgery. Methods: We screened Medline, Scopus, Cochrane Renal Library, and Google Scholar for randomized controlled trails in cardiac surgery for prevention or treatment of AKI in adults. Results: We identified 70 studies that contained a total of 5,554 participants published until November 2008. Most studies were small in sample size, were single-center, focused on preventive strategies, and displayed wide variation in AKI definitions. Only 26% were assessed to be of high quality according to the Jadad criteria. The types of strategies with possible protective efficacy were dopaminergic agents, vasodilators, anti-inflammatory agents, and pump/perfusion strategies. When analyzed separately, dopamine and N-acetylcysteine did not reduce the risk for AKI. Conclusions: This summary of all the literature on prevention and treatment strategies for AKI in cardiac surgery highlights the need for better information. The results advocate large, good-quality, multicenter studies to determine whether promising interventions reliably reduce rates of acute renal replacement therapy and mortality in the cardiac surgery setting.

Original languageEnglish (US)
Pages (from-to)408-418
Number of pages11
JournalAmerican Journal of Nephrology
Volume31
Issue number5
DOIs
StatePublished - May 1 2010

Fingerprint

Acute Kidney Injury
Thoracic Surgery
Therapeutics
Infusion Pumps
Dopamine Agents
Renal Replacement Therapy
Mortality
Acetylcysteine
Vasodilator Agents
Health Care Costs
Sample Size
Multicenter Studies
Dopamine
Anti-Inflammatory Agents
Randomized Controlled Trials
Kidney

Keywords

  • Acute kidney injury
  • Cardiac surgery
  • Healthcare costs
  • Prevention

ASJC Scopus subject areas

  • Nephrology

Cite this

Prevention and treatment of acute kidney injury in patients undergoing cardiac surgery : A systematic review. / Park, Meyeon; Coca, Steven G.; Nigwekar, Sagar U.; Garg, Amit X.; Garwood, Susan; Parikh, Chirag.

In: American Journal of Nephrology, Vol. 31, No. 5, 01.05.2010, p. 408-418.

Research output: Contribution to journalReview article

Park, Meyeon ; Coca, Steven G. ; Nigwekar, Sagar U. ; Garg, Amit X. ; Garwood, Susan ; Parikh, Chirag. / Prevention and treatment of acute kidney injury in patients undergoing cardiac surgery : A systematic review. In: American Journal of Nephrology. 2010 ; Vol. 31, No. 5. pp. 408-418.
@article{f03278468abd4387acec2f8b46183529,
title = "Prevention and treatment of acute kidney injury in patients undergoing cardiac surgery: A systematic review",
abstract = "Background: Acute kidney injury (AKI) is common in patients undergoing cardiac surgery and is associated with a high rate of death, long-term sequelae and healthcare costs. We conducted a systematic review of randomized controlled trials for strategies to prevent or treat AKI in cardiac surgery. Methods: We screened Medline, Scopus, Cochrane Renal Library, and Google Scholar for randomized controlled trails in cardiac surgery for prevention or treatment of AKI in adults. Results: We identified 70 studies that contained a total of 5,554 participants published until November 2008. Most studies were small in sample size, were single-center, focused on preventive strategies, and displayed wide variation in AKI definitions. Only 26{\%} were assessed to be of high quality according to the Jadad criteria. The types of strategies with possible protective efficacy were dopaminergic agents, vasodilators, anti-inflammatory agents, and pump/perfusion strategies. When analyzed separately, dopamine and N-acetylcysteine did not reduce the risk for AKI. Conclusions: This summary of all the literature on prevention and treatment strategies for AKI in cardiac surgery highlights the need for better information. The results advocate large, good-quality, multicenter studies to determine whether promising interventions reliably reduce rates of acute renal replacement therapy and mortality in the cardiac surgery setting.",
keywords = "Acute kidney injury, Cardiac surgery, Healthcare costs, Prevention",
author = "Meyeon Park and Coca, {Steven G.} and Nigwekar, {Sagar U.} and Garg, {Amit X.} and Susan Garwood and Chirag Parikh",
year = "2010",
month = "5",
day = "1",
doi = "10.1159/000296277",
language = "English (US)",
volume = "31",
pages = "408--418",
journal = "American Journal of Nephrology",
issn = "0250-8095",
publisher = "S. Karger AG",
number = "5",

}

TY - JOUR

T1 - Prevention and treatment of acute kidney injury in patients undergoing cardiac surgery

T2 - A systematic review

AU - Park, Meyeon

AU - Coca, Steven G.

AU - Nigwekar, Sagar U.

AU - Garg, Amit X.

AU - Garwood, Susan

AU - Parikh, Chirag

PY - 2010/5/1

Y1 - 2010/5/1

N2 - Background: Acute kidney injury (AKI) is common in patients undergoing cardiac surgery and is associated with a high rate of death, long-term sequelae and healthcare costs. We conducted a systematic review of randomized controlled trials for strategies to prevent or treat AKI in cardiac surgery. Methods: We screened Medline, Scopus, Cochrane Renal Library, and Google Scholar for randomized controlled trails in cardiac surgery for prevention or treatment of AKI in adults. Results: We identified 70 studies that contained a total of 5,554 participants published until November 2008. Most studies were small in sample size, were single-center, focused on preventive strategies, and displayed wide variation in AKI definitions. Only 26% were assessed to be of high quality according to the Jadad criteria. The types of strategies with possible protective efficacy were dopaminergic agents, vasodilators, anti-inflammatory agents, and pump/perfusion strategies. When analyzed separately, dopamine and N-acetylcysteine did not reduce the risk for AKI. Conclusions: This summary of all the literature on prevention and treatment strategies for AKI in cardiac surgery highlights the need for better information. The results advocate large, good-quality, multicenter studies to determine whether promising interventions reliably reduce rates of acute renal replacement therapy and mortality in the cardiac surgery setting.

AB - Background: Acute kidney injury (AKI) is common in patients undergoing cardiac surgery and is associated with a high rate of death, long-term sequelae and healthcare costs. We conducted a systematic review of randomized controlled trials for strategies to prevent or treat AKI in cardiac surgery. Methods: We screened Medline, Scopus, Cochrane Renal Library, and Google Scholar for randomized controlled trails in cardiac surgery for prevention or treatment of AKI in adults. Results: We identified 70 studies that contained a total of 5,554 participants published until November 2008. Most studies were small in sample size, were single-center, focused on preventive strategies, and displayed wide variation in AKI definitions. Only 26% were assessed to be of high quality according to the Jadad criteria. The types of strategies with possible protective efficacy were dopaminergic agents, vasodilators, anti-inflammatory agents, and pump/perfusion strategies. When analyzed separately, dopamine and N-acetylcysteine did not reduce the risk for AKI. Conclusions: This summary of all the literature on prevention and treatment strategies for AKI in cardiac surgery highlights the need for better information. The results advocate large, good-quality, multicenter studies to determine whether promising interventions reliably reduce rates of acute renal replacement therapy and mortality in the cardiac surgery setting.

KW - Acute kidney injury

KW - Cardiac surgery

KW - Healthcare costs

KW - Prevention

UR - http://www.scopus.com/inward/record.url?scp=77950326172&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77950326172&partnerID=8YFLogxK

U2 - 10.1159/000296277

DO - 10.1159/000296277

M3 - Review article

C2 - 20375494

AN - SCOPUS:77950326172

VL - 31

SP - 408

EP - 418

JO - American Journal of Nephrology

JF - American Journal of Nephrology

SN - 0250-8095

IS - 5

ER -