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Perioperative acute kidney injury: impact and recent update.
Ojo, Bukola; Campbell, Cedric H.
  • Ojo B; Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA.
  • Campbell CH; Department of Anesthesiology, Virginia Commonwealth University Health System, Richmond, Virginia, USA.
Curr Opin Anaesthesiol ; 35(2): 215-223, 2022 Apr 01.
Article in English | MEDLINE | ID: covidwho-1860920
ABSTRACT
PURPOSE OF REVIEW Acute kidney injury (AKI) is common in hospitalized patients and is a major risk factor for increased length of stay, morbidity, and mortality in postoperative patients. There are multiple barriers to reducing perioperative AKI - the etiology is multi-factorial and the diagnosis is fraught with issues. We review the recent literature on perioperative AKI and some considerations for anesthesiologists that examine the far-reaching effects of AKI on multiple organ systems. RECENT

FINDINGS:

This review will discuss recent literature that addresses the epidemiology, use of novel biomarkers in risk stratification, and therapeutic modalities for AKI in burn, pediatrics, sepsis, trauma, cardiac, and liver disease, contrast-induced AKI, as well as the evidence assessing goal-directed fluid therapy.

SUMMARY:

Recent studies address the use of risk stratification models and biomarkers, more sensitive than creatinine, in the preoperative identification of patients at risk for AKI. Although exciting, these scores and models need validation. There is a need for research assessing whether early AKI detection improves outcomes. Enhanced recovery after surgery utilizing goal-directed fluid therapy has not been shown to make an appreciable difference in the incidence of AKI. Reducing perioperative AKI requires a multi-pronged and possibly disease-specific approach.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Acute Kidney Injury Type of study: Diagnostic study / Etiology study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Child / Humans Language: English Journal: Curr Opin Anaesthesiol Journal subject: Anesthesiology Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Acute Kidney Injury Type of study: Diagnostic study / Etiology study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Child / Humans Language: English Journal: Curr Opin Anaesthesiol Journal subject: Anesthesiology Year: 2022 Document Type: Article