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Kidney 

Chapter:
Kidney
Author(s):

Neal Padmanabhan

DOI:
10.1093/med/9780199692958.003.0013
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date: 18 October 2019

The true incidence of acute kidney injury (AKI) in cardiac surgery is not clear, as there is significant variability in studies over how abrupt or severe the kidney dysfunction must be before it is defined as AKI. It is, however, a common complication of critical illness and an independent risk factor for postoperative death. The risk for death is proportional to the severity of kidney injury with mortality being as high as 50% in the general intensive care setting. Mortality is higher in patients with a sustained elevation of creatinine than in those who recover function. All patients undergoing cardiac surgery are at risk of AKI either through their presenting illness or subsequent iatrogenic injury. The most common pathogenesis of AKI following cardiac surgery is disrupted renal blood flow and the accepted prevention strategies are therefore: appropriate intravenous volume expansion, optimization of cardiac output, and maintenance of renal blood flow and renal perfusion pressure

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