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Determinants of acute kidney injury after cardiac surgery: a systematic review

Authors :
Grigore Tinica
Crischentian Brinza
Adrian Covic
Iolanda Valentina Popa
Andrei Tarus
Alberto Emanuel Bacusca
Alexandru Burlacu
Source :
Reviews in Cardiovascular Medicine, Vol 21, Iss 4, Pp 601-610 (2020)
Publication Year :
2020
Publisher :
IMR Press, 2020.

Abstract

Acute kidney injury following cardiac surgery (CS-AKI) represents a severe postoperative complication, negatively impacting short-term and long-term mortality. Due to the lack of a specific treatment, effective prevention remains the most powerful tool to overcome the CS-AKI burden. Improving the preventive strategies is possible by establishing appropriate preoperative risk profiles. Various clinical models were proposed as a means to assist physicians in stratifying the risk of CS-AKI. However, these models are used for predicting severe forms of CS-AKI, while their predictive power for mild forms is insufficient. Our paper represents the first systematic approach to review all proposed preoperative risk factors and their predictive power. Our strategy is the starting point for selecting and comparing the predictive elements to be integrated into future risk models. Heart failure, chronic hyperglycemia, anemia, obesity, preoperative exposure to nephrotoxic drugs or contrast media, inflammation, proteinuria, and pre-existing kidney disease were systematically reviewed and were found to be associated with an increased risk of postoperative CS-AKI. As no externally validated and universally accepted risk models currently exist, the clinical judgment and a good knowledge of the preoperative risk factors in the light of new evidence may help personalize preoperative risk profiles as the cornerstone of prevention measures.

Details

Language :
English
ISSN :
15306550
Volume :
21
Issue :
4
Database :
Directory of Open Access Journals
Journal :
Reviews in Cardiovascular Medicine
Publication Type :
Academic Journal
Accession number :
edsdoj.183e8944f1144baa57d0bda33a1b7aa
Document Type :
article
Full Text :
https://doi.org/10.31083/j.rcm.2020.04.206