Renal Failure and Dialysis

Abstract

Acute kidney injury (AKI) is a common and serious complication of cardiac surgery. The spectrum of cardiac surgery-associated AKI (CS-AKI) ranges from transient loss of renal reserve, through AKI, to long-term irreversible renal failure requiring renal replacement therapy (RRT). Notably, CS-AKI is also associated with numerous complications including: short and long-term mortality; development and progression of chronic kidney disease (CKD); extended hospital and intensive care unit (ICU) lengths of stay; and hospital readmission (Brown et al. Ann Thorac Surg 97(1):111-117, 2014; Pickering et al. Am J Kidney Dis 65(2):283-293, 2015; Xu et al. Medicine 94(45):e2025, 2015; Hu et al. J Cardiothorac Vasc Anesth 30(1):82-89, 2016). Thus, a review of avoidable CS-AKI sources, and interventions that preserve or promote recovery of renal function is highly pertinent to care of cardiac surgical patients.