Practice implications of recent clinical trials for the prevention of acute kidney injury in cardiovascular surgery.
Acute kidney injury in patients undergoing cardiovascular surgery is a complex problem with associated increased risks for dialysis, short- and long-term mortality, and progression to end-stage renal disease. Interventions to prevent and treat renal complications in this cohort have seldom been uniformly satisfactory due to the differences in strategies for intervention, drug doses and duration of treatment, baseline renal functions, and population studied. Nonetheless, significant advances have been made and include recognition of the effect of preexisting organ dysfunction on renal outcomes, reassessment of existing therapeutic interventions, and exploration of the feasibility of newer agents to prevent and treat acute kidney injury in cardiovascular surgery patients. This article briefly reviews several of these issues with an emphasis on recent clinical trials in this cohort.
Shimada
Michiko
M
Division of Renal Diseases and Hypertension, University of Colorado Health Sciences Center, Denver, CO, USA.
Dass
Bhagwan
B
Dhatt
Gurjit S
GS
Alsabbagh
Mourad M
MM
Asmar
Abdo R
AR
Ather
Imtiaz M
IM
Sharma
Rajni
R
Ejaz
A Ahsan
AA
D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D000975:Antioxidants / Q000627:therapeutic use; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects*; D002986:Clinical Trials as Topic; D018450:Disease Progression; D042241:Early Diagnosis; D005440:Fluid Therapy / Q000379:methods; D017052:Hospital Mortality; D020445:Hospitalists / Q000379:methods; D006801:Humans; D015994:Incidence; D045283:Natriuretic Agents / Q000627:therapeutic use; D019990:Perioperative Care / Q000379:methods; D006435:Renal Dialysis; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
D000975:Antioxidants; D045283:Natriuretic Agents; D014665:Vasodilator Agents