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Cardiac surgery and acute kidney injury: emerging concepts.

Publication ,  Journal Article
Stafford-Smith, M; Shaw, A; Swaminathan, M
Published in: Curr Opin Crit Care
December 2009

PURPOSE OF REVIEW: To review recent advances in understanding of the occurrence, pathophysiology, prophylaxis and treatment of cardiac surgery-associated acute kidney injury (AKI). RECENT FINDINGS: New definitions and prompt diagnostic tools, enhanced risk stratification strategies, avoidance of nephrotoxins and procedure selection are all areas in which recent contributions to the literature have improved perioperative care for cardiac surgery patients. Although evidence continues to confirm the adverse effects of extreme hemodilution and transfusion as part of cardiac surgery, the previously believed advantages of tight perioperative glucose control for the kidney are being questioned in recent studies. Although very little evidence from randomized trials in cardiac surgery populations supports specific interventions to protect or prevent AKI, recent reports indicate reduced AKI associated with some procedural innovations, and the hope that promising findings for agents such as sodium bicarbonate that require further study may yield effective therapies. SUMMARY: The vexing problem of AKI following cardiac surgery is common and unsolved. Clinical strategies that stress avoidance rather than treatment remain the mainstay of effective management of patients at high renal risk.

Duke Scholars

Published In

Curr Opin Crit Care

DOI

EISSN

1531-7072

Publication Date

December 2009

Volume

15

Issue

6

Start / End Page

498 / 502

Location

United States

Related Subject Headings

  • Thoracic Surgery
  • Postoperative Complications
  • Humans
  • Emergency & Critical Care Medicine
  • Acute Kidney Injury
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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ICMJE
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Stafford-Smith, M., Shaw, A., & Swaminathan, M. (2009). Cardiac surgery and acute kidney injury: emerging concepts. Curr Opin Crit Care, 15(6), 498–502. https://doi.org/10.1097/MCC.0b013e328332f753
Stafford-Smith, Mark, Andrew Shaw, and Madhav Swaminathan. “Cardiac surgery and acute kidney injury: emerging concepts.Curr Opin Crit Care 15, no. 6 (December 2009): 498–502. https://doi.org/10.1097/MCC.0b013e328332f753.
Stafford-Smith M, Shaw A, Swaminathan M. Cardiac surgery and acute kidney injury: emerging concepts. Curr Opin Crit Care. 2009 Dec;15(6):498–502.
Stafford-Smith, Mark, et al. “Cardiac surgery and acute kidney injury: emerging concepts.Curr Opin Crit Care, vol. 15, no. 6, Dec. 2009, pp. 498–502. Pubmed, doi:10.1097/MCC.0b013e328332f753.
Stafford-Smith M, Shaw A, Swaminathan M. Cardiac surgery and acute kidney injury: emerging concepts. Curr Opin Crit Care. 2009 Dec;15(6):498–502.

Published In

Curr Opin Crit Care

DOI

EISSN

1531-7072

Publication Date

December 2009

Volume

15

Issue

6

Start / End Page

498 / 502

Location

United States

Related Subject Headings

  • Thoracic Surgery
  • Postoperative Complications
  • Humans
  • Emergency & Critical Care Medicine
  • Acute Kidney Injury
  • 3202 Clinical sciences
  • 1103 Clinical Sciences