Acta clinica Croatica, Vol. 60. No. 1., 2021.
Review article
https://doi.org/10.20471/acc.2021.60.01.17
Acute Kidney Injury after Open-Heart Surgery Procedures
Anže Djordjević
; Maribor University Medical Center, Department of Cardiac Surgery, Maribor, Slovenia
Stamenko Šušak
; Institute of Cardiovascular Diseases of Vojvodina, Department of Cardiovascular Surgery, Sremska Kamenica, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Lazar Velicki
; Institute of Cardiovascular Diseases of Vojvodina, Department of Cardiovascular Surgery, Sremska Kamenica, Serbia; University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
Miha Antonič
; Maribor University Medical Center, Department of Cardiac Surgery, Maribor, Slovenia; University of Maribor, Faculty of Medicine, Maribor, Slovenia
Abstract
Cardiac surgery-associated acute kidney injury (CS-AKI) is a major complication
associated with increased morbidity and mortality. There are multiple diagnostic criteria for CS-AKI.
Despite many new investigations available for improved AKI diagnostics, creatinine and urea remain
the cornerstone of diagnostics in everyday clinical practice. There are three major pathophysiological
mechanisms that contribute to kidney injury, i.e. renal hypoperfusion, inflammation with oxidative
stress, and use of nephrotoxic agents. Some risk factors have been identified that can be modified during
the course of treatment (use of nephrotoxic agents, duration of cardiopulmonary bypass, type of
extracorporeal circulation, postoperative low cardiac output or hypotension). The aim of AKI prevention
should always be to prevent aggravation of renal failure and, if possible, to avoid progression to
renal replacement therapy, which in turn brings worse long-term outcomes.
Keywords
Kidney injuries; Cardiac surgery; Perfusion; Oxidative stress; Dialysis
Hrčak ID:
259905
URI
Publication date:
1.3.2021.
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