title: Update on clinical trials for the prevention of acute kidney injury in patients undergoing cardiac surgery.
abstract: BACKGROUND
  Effective therapeutic agents for the prevention and treatment of acute kidney injury (AKI) after cardiac surgery remain elusive despite the tremendous advances in surgical techniques, technology, and understanding of disease processes. Recent developments and their effect on the incidence of AKI after cardiac surgery are discussed.
  
  
  METHODS
  Published clinical trials in PubMed, strength of evidence assessed by the guidelines of the American Family Physicians.
  
  
  CONCLUSIONS
  The definition of AKI has changed, and the focus of interventions has shifted from treatment to prevention to recovery from AKI. Antioxidants and biological agents have been added to classic armaments of hydration and diuretics in addition to tighter metabolic control to prevent AKI. Although the treatment options remain unsatisfactory, a lot of progress nevertheless continues to be made in the prevention and treatment of AKI.
authors: Division of Nephrology, Hypertension, and Renal Transplantation, University of Florida, P.O. Box 100224, Gainesville, FL 32610-0224, USA.
authors: Mourad M
authors: MM
authors: Alsabbagh
authors: Abdo
authors: A
authors: Asmar
authors: Noel I
authors: NI
authors: Ejaz
authors: Ravi K
authors: RK
authors: Aiyer
authors: Ganesh
authors: G
authors: Kambhampati
authors: A Ahsan
authors: AA
authors: Ejaz
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D000975:Antioxidants / Q000008:administration & dosage; D001786:Blood Glucose / Q000378:metabolism; D001803:Blood Transfusion; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D002986:Clinical Trials as Topic; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects; D047549:Coronary Artery Bypass, Off-Pump; D004232:Diuretics / Q000008:administration & dosage; D004298:Dopamine / Q000008:administration & dosage; D018818:Fenoldopam / Q000008:administration & dosage; D005440:Fluid Therapy / Q000379:methods; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D007036:Hypothermia, Induced; D007423:Intra-Aortic Balloon Pumping; D045265:Natriuretic Peptides / Q000008:administration & dosage; D019990:Perioperative Care / Q000379:methods; D059035:Perioperative Period; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000975:Antioxidants; D001786:Blood Glucose; D002317:Cardiovascular Agents; D003287:Contrast Media; D004232:Diuretics; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D045265:Natriuretic Peptides; D014665:Vasodilator Agents; D018818:Fenoldopam; D004298:Dopamine