Renal protection strategies
The well-known quote from the renal physiologist Dr. Homer Smith as he proposed that the composition of the blood is determined not by what the mouth ingests but by what the kidneys keep.1 highlights not only the kidneys' domain of influence, but why even the smallest functional perturbations can have widespread effects. The kidney plays a central role in homeostasis, including keeping extracellular composition and fluid volume constant, while excreting toxins and metabolic waste in the urine. Acute kidney injury (AKI) is a major complication of aortic surgery and highly associated with poor outcome. © 2011 Springer Science+Business Media, LLC.