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Acute kidney injury following cardiac surgery: role of perioperative blood pressure control.

Publication ,  Journal Article
Weir, MR; Aronson, S; Avery, EG; Pollack, CV
Published in: Am J Nephrol
2011

BACKGROUND/AIMS: Patients who develop acute kidney injury (AKI) after cardiac surgery continue to have a high mortality rate. Although factors that predispose to postoperative renal dysfunction have been identified, this knowledge has not been associated with a substantial reduction in the incidence of this serious adverse event. METHODS: This review uses the existing literature to explore the relationship between AKI and perioperative blood pressure (BP) control in cardiac surgery patients. The results of recent novel analyses are introduced, and the implications of these studies for the management of cardiac surgery patients in the perioperative period are discussed. RESULTS: Preexisting isolated systolic hypertension and wide pulse pressure increase the risk of postoperative renal dysfunction in the cardiac surgery population. New data suggest that BP lability (i.e., BP excursions outside an acceptable physiologic range) during cardiac surgery may also be an important predictor of subsequent renal dysfunction. CONCLUSION: Recently published data suggest that perioperative BP lability influences both the risk of postoperative renal dysfunction and 30-day mortality. Future studies will determine whether the use of agents that allow improved BP control within a desirable range will reduce the incidence of postoperative AKI in cardiac surgery patients.

Duke Scholars

Published In

Am J Nephrol

DOI

EISSN

1421-9670

Publication Date

2011

Volume

33

Issue

5

Start / End Page

438 / 452

Location

Switzerland

Related Subject Headings

  • Urology & Nephrology
  • Treatment Outcome
  • Time Factors
  • Thoracic Surgery
  • Risk Factors
  • Prognosis
  • Postoperative Complications
  • Hypertension
  • Humans
  • Glomerular Filtration Rate
 

Citation

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Weir, M. R., Aronson, S., Avery, E. G., & Pollack, C. V. (2011). Acute kidney injury following cardiac surgery: role of perioperative blood pressure control. Am J Nephrol, 33(5), 438–452. https://doi.org/10.1159/000327601
Weir, Matthew R., Solomon Aronson, Edwin G. Avery, and Charles V. Pollack. “Acute kidney injury following cardiac surgery: role of perioperative blood pressure control.Am J Nephrol 33, no. 5 (2011): 438–52. https://doi.org/10.1159/000327601.
Weir MR, Aronson S, Avery EG, Pollack CV. Acute kidney injury following cardiac surgery: role of perioperative blood pressure control. Am J Nephrol. 2011;33(5):438–52.
Weir, Matthew R., et al. “Acute kidney injury following cardiac surgery: role of perioperative blood pressure control.Am J Nephrol, vol. 33, no. 5, 2011, pp. 438–52. Pubmed, doi:10.1159/000327601.
Weir MR, Aronson S, Avery EG, Pollack CV. Acute kidney injury following cardiac surgery: role of perioperative blood pressure control. Am J Nephrol. 2011;33(5):438–452.
Journal cover image

Published In

Am J Nephrol

DOI

EISSN

1421-9670

Publication Date

2011

Volume

33

Issue

5

Start / End Page

438 / 452

Location

Switzerland

Related Subject Headings

  • Urology & Nephrology
  • Treatment Outcome
  • Time Factors
  • Thoracic Surgery
  • Risk Factors
  • Prognosis
  • Postoperative Complications
  • Hypertension
  • Humans
  • Glomerular Filtration Rate