Update on perioperative acute kidney injury.
In this review, we discuss the latest updates on perioperative acute kidney injury (AKI) and the specific considerations that are relevant to different surgeries and patient populations.



AKI diagnosis is constantly evolving. New biomarkers detect AKI early and shed a light on the possible cause of AKI. Hypotension, even for a short duration, is associated with perioperative AKI. The debate on the deleterious effects of chloride-rich solutions is still far from conclusion. Remote ischemic preconditioning is showing promising results in the possible prevention of perioperative AKI. No definite data show a beneficiary effect of statins, fenoldepam, or sodium bicarbonate in preventing AKI.



Perioperative AKI is prevalent and associated with significant morbidity and mortality. Considering the lack of effective preventive or therapeutic interventions, this review focuses on perioperative AKI: measures for early diagnosis, defining risks and possible mechanisms, and summarizing current knowledge for intraoperative fluid and hemodynamic management to reduce risk of AKI.
Division of Anesthesiology, Pain, and Intensive Care, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel.
Or
O
Goren
Idit
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Matot
D058186:Acute Kidney Injury / Q000517:prevention & control*; D015415:Biomarkers; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019194:Ischemic Preconditioning / Q000009:adverse effects / Q000379:methods; D019990:Perioperative Care / Q000379:methods*; D059035:Perioperative Period; D013514:Surgical Procedures, Operative / Q000009:adverse effects*
D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors