Perioperative renal protection.
Acute kidney injury (AKI) is a significant cause of perioperative patient morbidity and mortality. The definition of AKI has recently changed and further research is underway to identify clinically relevant biomarkers to aid in the diagnosis of the syndrome. AKI is often multi-factorial in origin and patients with certain preoperative risk factors are at elevated risk of perioperative AKI. An anesthesiologist's main objective for perioperative renal protection is prevention by maintenance of euvolemia, preservation of adequate renal perfusion, and avoidance of nephrotoxins. This review will address the definition and diagnosis of AKI, identify patients at risk of AKI, and critically appraise management options for perioperative renal protection.
Jones
Dean R
DR
Department of Anesthesiology, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
Lee
H Thomas
HT
D058186:Acute Kidney Injury / Q000145:classification / Q000209:etiology / Q000517:prevention & control; D000776:Anesthesiology; D015415:Biomarkers; D003404:Creatinine / Q000097:blood; D018491:Dopamine Agonists / Q000627:therapeutic use; D018818:Fenoldopam / Q000627:therapeutic use; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D007668:Kidney / Q000098:blood supply; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D012307:Risk Factors
D015415:Biomarkers; D018491:Dopamine Agonists; D003404:Creatinine; D018818:Fenoldopam