title: Peri-operative renal dysfunction: prevention and management.
abstract: Postoperative increases in serum creatinine concentration, by amounts historically viewed as trivial, are associated with increased morbidity and mortality. Acute kidney injury is common, affecting one in five patients admitted with acute medical disease and up to four in five patients admitted to intensive care, of whom one in two have had operations. This review is focused principally on the identification of patients at risk of acute kidney injury and the prevention of injury. In the main, there are no interventions that directly treat the damaged kidney. The management of acute kidney injury is based on correction of dehydration, hypotension, and urinary tract obstruction, stopping nephrotoxic drugs, giving antibiotics for bacterial infection, and commencing renal replacement therapy if necessary.
authors.affiliation: Department of Intensive Care Medicine, Royal Surrey County Hospital, Guildford, Surrey, UK.
authors.forename: D
authors.initials: D
authors.lastname: Golden
authors.affiliation: Department of Intensive Care Medicine, Royal Surrey County Hospital, Guildford, Surrey, UK.
authors.forename: J
authors.initials: J
authors.lastname: Corbett
authors.affiliation: Department of Intensive Care Medicine, Royal Surrey County Hospital, Guildford, Surrey, UK.|Surrey Peri-operative Anaesthesia and Critical Care Collaborative Research Group and Faculty of Health Care Sciences, University of Surrey, Guildford, Surrey, UK.
authors.forename: L G
authors.initials: LG
authors.lastname: Forni
mesh_terms: D058186:Acute Kidney Injury / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy*; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007677:Kidney Function Tests; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy*; D017582:Renal Replacement Therapy; D012307:Risk Factors