Management of post-operative acute kidney injury

Samira Bell (Lead / Corresponding author), Victoria C. Ross, Katherine A. Zealley, Fergus Millar, Chris Isles

Research output: Contribution to journalArticle

5 Citations (Scopus)
174 Downloads (Pure)

Abstract

Post-operative Acute Kidney Injury (AKI) is a common complication of surgery with significant short and long term adverse consequences. The adoption of diagnostic criteria for AKI (RIFLE, AKIN, KDIGO) has facilitated comparison of data reported by different centres, confirming that even mild AKI is associated with excess mortality. It remains unclear whether this is caused by the kidney injury itself or whether AKI is simply a marker of underlying disease severity. There is no trial evidence to support the use of any specific therapeutic intervention in post-operative AKI. Best current treatment is therefore preventative by optimising hydration and avoidance of nephrotoxins, emphasising the importance of earlier detection and identification of individuals at high risk for AKI. In this review, we examine the latest literature on the management of post-operative AKI in adult patients, specifically the diagnosis and definition of AKI, epidemiology and pathogenesis and risk stratification in cardiac and non- cardiac surgery. We also review the latest evidence on pharmacological and non- pharmacological interventions.
Original languageEnglish
Pages (from-to)695-700
Number of pages6
JournalQJM : an International Journal of Medicine
Volume110
Issue number11
Early online date18 Oct 2016
DOIs
Publication statusPublished - Nov 2017

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