Renal Complications and Their Management After Adult Cardiac Surgery

  • Juan M. PerroneEmail author
  • Gaston Cudemus


Acute kidney injury (AKI) is a serious postoperative complication following cardiac surgery. Despite the incidence of AKI requiring temporary renal replacement therapy being low, it is nonetheless associated with high morbidity and mortality. Therefore, preventing AKI associated with cardiac surgery can dramatically improve outcomes in these patients. The pathogenesis of AKI is multifactorial, and many attempts to prevent or treat renal injury have been met with limited success. This chapter will discuss the incidence and risk factors for cardiac surgery-associated AKI, including the pathophysiology, potential biomarkers of injury, and treatment modalities.


Epidemiology Definition and staging Pathophysiology Nephrotoxins Ischemia and ischemia-reperfusion injury Atheroembolism Exposure to CPB Risk factors and biomarkers Strategies for renal protection and management of CSA-AKI Strategies for renal protection Cardiopulmonary bypass management of CSA-AKI General principles Postoperative management Renal replacement therapy 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Anesthesiology, Critical Care and Pain MedicineMassachusetts General Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Cardiothoracic Anesthesiology and Critical Care, Department of Anesthesia, Critical Care and Pain MedicineCorrigan Minehan Heart CenterBostonUSA
  3. 3.Division of Cardiac SurgeryMassachusetts General Hospital, Harvard Medical SchoolBostonUSA

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