Key result
Current management of post-operative acute kidney injury relies on prevention through optimized hydration and avoidance of nephrotoxins, as no trial evidence supports specific therapeutic interventions.
Current management of post-operative AKI relies on prevention through hydration and avoidance of nephrotoxins, as no specific therapeutic interventions are supported by trial evidence.
Supports preventive strategies as mainstay for post-operative AKI; leaves open need for RCTs on targeted therapies.
Post-operative acute kidney injury (AKI) is a common complication of surgery with significant short- and long-term adverse consequences. The adoption of diagnostic criteria for AKI (RIFLE, AKIN and KDIGO) has facilitated comparison of data reported by different centres, confirming that even mild AKI is associated with excess mortality. It remains unclear whether this is caused by the kidney injury itself or whether AKI is simply a marker of underlying disease severity. There is no trial evidence to support the use of any specific therapeutic intervention in post-operative AKI. Best current treatment is, therefore, preventative by optimizing hydration and avoidance of nephrotoxins, emphasizing the importance of earlier detection and identification of individuals at high risk for AKI. In this review, we examine the latest literature on the management of post-operative AKI in adult patients, specifically the diagnosis and definition of AKI, epidemiology and pathogenesis and risk stratification in cardiac and non-cardiac surgery. We also review the latest evidence on pharmacological and non-pharmacological interventions.
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Bell et al. (2016) conducted a review in Post-operative acute kidney injury (AKI). Pharmacological and non-pharmacological interventions was evaluated. Current management of post-operative acute kidney injury relies on prevention through optimized hydration and avoidance of nephrotoxins, as no trial evidence supports specific therapeutic interventions.
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