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Cardiac Surgery Acute Kidney Injury: Controversy in Renal Support

  • Aaron M. ChengEmail author
  • Seth Wright
Chapter
Part of the Difficult Decisions in Surgery: An Evidence-Based Approach book series (DDSURGERY)

Abstract

Acute kidney injury (AKI) is a common complication after cardiac surgery and is associated with increased patient morbidity and mortality including hospital readmissions. Cardiac surgery-associated acute kidney injury (CS-AKI) manifests often in the post-operative setting and is frequently related to patient co-morbidities as well as intraoperative factors that are not easily modifiable. Detecting AKI usually relies on decreases in urine output and acute increases in serum creatinine, and management in the post-operative period focuses on reducing ongoing renal insult, prudent management of perioperative hemodynamics and patient volume status. When acute renal failure occurs, renal replacement therapies (RRT) are commonly required for management of these critically ill patients, although debate persists on the optimal timing to initiate RRT when acute renal injury occurs after cardiac surgery.

Keywords

Acute kidney injury Cardiac surgery acute kidney injury Post cardiac surgery Cardiac surgery Renal replacement therapy Hemofiltration Dialysis 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.University of Washington, Department of Surgery, Division of Cardiothoracic SurgerySeattleUSA
  2. 2.University Washington Medical Center Cardiothoracic ICUSeattleUSA
  3. 3.Tufts Medical Center, Department of Medicine, Division of NephrologyBostonUSA

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