-
- M Küllmar and M Meersch.
- Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude A1, 48149, Münster, Deutschland.
- Anaesthesist. 2019 Apr 1; 68 (4): 194-201.
BackgroundAcute kidney injury (AKI) is a frequent complication in the perioperative period and is associated with a high morbidity and mortality. AKI is an independent risk factor for adverse outcome. The Kidney Disease: Improving Global Outcome (KDIGO) guidelines define AKI based on increases in serum creatinine and/or urinary output. Since there is no causal therapy available, early detection and timely implementation of preventive measures are of particular importance.ObjectiveThis article gives an overview of the disease picture of perioperative AKI. The recommendations on diagnostics, prevention and treatment are presented.MethodsThe available evidence is summarized based on the currently available literature.ResultsNew renal biomarkers demonstrate kidney stress and are able to make an early prediction of the development of AKI. The implementation of the KDIGO bundles (discontinuation of all nephrotoxic medications, optimization of the volume status and perfusion pressure, consideration of an extended functional hemodynamic monitoring, close monitoring of serum creatinine concentration and urine output, avoidance of hyperglycemia and consideration of alternatives to radiocontrast agents) and remote ischemic preconditioning have shown a significant reduction in the incidence of AKI in high-risk patients.ConclusionFor timely diagnosis and prevention of AKI the recommendations for action of the KDIGO guidelines should be implemented. High-risk patients should be detected early in the perioperative period in order to be able to initiate preemptive strategies in a timely manner.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:
![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.