Acute Kidney Injury in the Perioperative Period: Beyond the Obvious

Martínez Diego Escarramán,Sánchez Bertha M Córdova,Rojas Miguel Ángel Martínez,Gutiérrez Manuel Alberto Guerrero,Nieto Orlando Rubén Pérez,Lopez Eder Ivan Zamarrón,Diaz Jesús Salvador Sánchez,Aguilar José Antonio Meade

doi:10.23937/2377-4630/1410129

Martínez Diego Escarramán, Sánchez Bertha M Córdova + Show 6 more

Open Access

https://doi.org/10.23937/2377-4630/1410129

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Abstract

Acute kidney injury (AKI) represents a great challenge for the anesthesiologist during the perioperative period, since its presence directly impacts in patients mortality and morbidity, even after its resolution as a result of multiples factors. Furthermore, it is characterized by coexisting with a great variety of systemic alterations, which add special difficulty to its study and understanding. During perioperative period there may be ischemic insult and non-ischemic insult, on the other hand, volume overload (hypervolemia) can also cause alteration on kidney function by modifying the consumption and delivery of renal oxygen.

Highlights

Acute kidney injury (AKI) is the most frequent syndrome in hospitalized patients, its prevalence has been measured from 15% to more than 50% depending on the statistics of each service, whether chest surgery, oncology, transplants or intensive care units [1]
It is characterized by coexisting with a great variety of systemic alterations, which add special difficulty to its study and understanding, making individualized treatments necessary in each of its presentations: Cardiorenal syndrome [2], hepatorenal syndrome [3], nephrotoxicity [4] or sepsis associated [5]
The most important thing, indubitably, is that its presence impacts the prognosis of the patient through an increase in morbidity and mortality which persists even after the resolution of the AKI itself [6], this can be explained by factors such as: Endothelial dysfunction [7], myocardial remodeling [8], increased oxidative stress [9] and epigenetic factors [10]

Summary

Introduction

Acute kidney injury (AKI) is the most frequent syndrome in hospitalized patients, its prevalence has been measured from 15% to more than 50% depending on the statistics of each service, whether chest surgery, oncology, transplants or intensive care units [1]. It is characterized by coexisting with a great variety of systemic alterations, which add special difficulty to its study and understanding, making individualized treatments necessary in each of its presentations: Cardiorenal syndrome [2], hepatorenal syndrome [3], nephrotoxicity [4] or sepsis associated [5].

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Conclusion