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Renal Failure After Cardiac Surgery

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Cardiac Surgery

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Abstract

Acute kidney injury (AKI) is the most common clinically important complication after cardiac surgery. In critically ill patients, cardiac surgery is the second most common cause of AKI after sepsis. The development of acute kidney injury is independently associated with significant short- and long-term morbidity and mortality. In this chapter, we explore the definition of cardiac surgery associated acute kidney injury (CSA-AKI), and identify its risk factors. We discuss current theories of the pathophysiology of CSA-AKI and describe its clinical course. Furthermore, we introduce diagnostic tools with particular reference to novel biomarkers of AKI and their potential utility. We also analyze currently applied interventions aimed at attenuating AKI in patients undergoing cardiac surgery. Finally, we explore issues in the use of renal replacement therapy, its timing and its preferred modalities in patients with CSA-AKI, and discuss the prognosis of CSA-AKI in terms of patient survival and kidney recovery.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology and Critical Care, Hospital Universitari Dr. Josep Trueta, Universitat de Girona, Girona, Spain

    Marc Vives

  2. Department of Cardiac Surgey, Hospital Clinico Universitario de Valladolid, Valladolid, Spain

    Juan Bustamante-Munguira

Authors
  1. Marc Vives
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  2. Juan Bustamante-Munguira
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Correspondence to Marc Vives .

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Editors and Affiliations

  1. Harefield Hospital, Royal Brompton & Harefield NHS Trust, London, UK

    Shahzad G. Raja

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Vives, M., Bustamante-Munguira, J. (2020). Renal Failure After Cardiac Surgery. In: Raja, S. (eds) Cardiac Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-24174-2_82

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  • DOI: https://doi.org/10.1007/978-3-030-24174-2_82

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-24173-5

  • Online ISBN: 978-3-030-24174-2

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