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Acute Kidney Injury Associated with Cardiac Surgery

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Redo Cardiac Surgery in Adults

Abstract

Acute renal failure (ARF) or acute kidney injury (AKI), depending on the specific definition, occurs in up to 30% of patients undergoing cardiac surgery. ARF that requires dialysis (ARF-D) occurs in approximately 1% of patients undergoing cardiac surgery (Nephrol Dial Transplant 14:1158–62, 1999; Ann Intern Med 128:194–203, 1998; J Thorac Cardiovasc Surg 71:323–33, 1976, 79:241–3, 1980; Intensive Care Med 26:565–71, 2000; J Thorac Cardiovasc Surg 41:237–41, 1993, 107:1489–95, 1994; Aust N Z J Med 25:284–9, 1995; Eur J Cardiothorac Surg 25:597–604, 2004; Br Med J 1:415–8, 1972; Ann Int Med 84:677–82, 1976; J Thorac Cardiovasc Surg 77:880–8, 1979, 98:1107–12, 1989; Contrib Nephrol 93:98–104, 1991; Am J Med 104:34–8, 1998). The development of kidney injury is associated with a high mortality, a more complicated hospital course, and a higher risk of infectious complications (Nephrol Dial Transplant 14:1158–62, 1999; Ann Intern Med 128:194–203, 1998; J Thorac Cardiovasc Surg 71:323–33, 1976, 79:241–3, 1980; Intensive Care Med 26:565–71, 2000; J Thorac Cardiovasc Surg 41:237–41, 1993, 107:1489–95, 1994; Aust N Z J Med 25:284–9, 1995; Eur J Cardiothorac Surg 25:597–604, 2004; Br Med J 1:415–8, 1972; Ann Int Med 84:677–82, 1976; J Thorac Cardiovasc Surg 77:880–8, 1979, 98:1107–12, 1989; Contrib Nephrol 93:98–104, 1991; Am J Med 104:34–8, 1998). Even minimal changes in serum creatinine during the postoperative period are associated with a substantial decrease in survival (J Am Soc Nephrol 15:1597-–605, 2004). Furthermore, the majority of patients who develop ARF-D remain dialysis dependent, leading to significant long-term morbidity and mortality (Am J Cardiol 93:353–6, 2004).

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Copyright Acknowledgement

This material was previously published in The Clinical Journal of the American Society of Nephrology and is reproduced with the kind permission of the American Society of Nephrology.

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  1. Division of Nephrology, University of Virginia Health System, Charlottesville, VA, USA

    Mitchell H. Rosner MD

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  1. Centre Ave 5200, Pittsburgh, 15232-1300, Pennsylvania, USA

    V.R. Machiraju

  2. , Division of Cardiovascular Surgery, Mayo Clinic, First Street SW 200, Rochester, 55905, Minnesota, USA

    Hartzell V. Schaff

  3. , Department of Thoracic and Cardiovascula, Cleveland Clinic Foundation, Euclid Avenue 9500, Cleveland, 44195, Ohio, USA

    Lars G. Svensson

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Rosner, M.H. (2012). Acute Kidney Injury Associated with Cardiac Surgery. In: Machiraju, V., Schaff, H., Svensson, L. (eds) Redo Cardiac Surgery in Adults. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1326-4_5

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