Risk factors and early intervention of perioperative acute kidney injury

Abstract

Background The incidence of perioperative acute kidney injury (AKI) recently rises up. AKI not only prolongs hospital stay but also increases patients′ financial burden. Objective To review the risk factors of perioperative AKI to provide information for its effective intervention and prevention. Content Perioperative AKI is a common syndrome showing rapid reduction in glomerular filtration rate and accumulation of poisonous wastes in urine within a week following major surgeries. The direct cause of AKI is sustained contraction of the renal artery. Perioperative risk factors for AKI include age, gender, obesity, and preoperative health status (chronic kidney diseases, diabetes, chronic obstruction pulmonary disease, cardiovascular disease, etc.), the duration and special procedures of the operation, and application of drugs affecting kidney function. Serum creatinine is a valid biomarker for the damage of the kidney. The treatment of perioperative AKI includes the elimination of drugs toxic to kidney, improvement of hemodynamics and reduction of kidney cell apoptosis. Trend To reduce the incidence of AKI, cautions need to be taken to avoid of prescribing medications that are toxic to the kidney to susceptible patients. Serum creatinine should be monitored for early diagnosis, intervention and prevention of perioperative AKI. Key words: Acute kidney injury; Perioperative period; Risk factor; Biomarker