Review
Medicine, General & Internal
Christina Massoth, Alexander Zarbock
Summary: Acute kidney injury after cardiac surgery presents specific patterns of damage and recovery, which are crucial for management and outcomes. The KDIGO classification only partially covers the conceptual framework and is insufficient for a comprehensive diagnosis. This review discusses the strengths and limitations of recent criteria for CSA-AKI and provides an overview of biomarkers. The evolving understanding of CSA-AKI as a time-sensitive condition has led to an increased demand for enhancing diagnostic criteria and implementing biomarkers in clinical practice.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Multidisciplinary Sciences
Yichuan Wang, Xuliang Huang, Shanshan Xia, Qingqing Huang, Jue Wang, Maochao Ding, Yunchang Mo, Jianping Yang
Summary: There is no gender gap in AKI frequency for cardiac surgery patients below and above 60 years old. However, women exhibit increased AKI severity and extended intubation duration.
Article
Cardiac & Cardiovascular Systems
Benjamin R. Griffin, J. Pedro Teixeira, Sophia Ambruso, Michael Bronsert, Jay D. Pal, Joseph C. Cleveland, T. Brett Reece, David A. Fullerton, Sarah Faubel, Muhammad Aftab
Summary: This study aimed to investigate the association between stage 1 AKI after surgery and postoperative infection and mortality. The results showed that stage 1 AKI was independently associated with increased infection, ICU LOS, and hospital LOS. Treatment strategies focusing on AKI prevention, early recognition, and optimal medical management may reduce significant postoperative morbidity.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2021)
Article
Anesthesiology
Yi Shun Wang, Dong Xu Chen, Min Yan, Zhong Wu, Ying Qiang Guo, Qian Li, Lei Du
Summary: This study developed and validated a model to predict the severity of acute kidney injury (AKI) after on-pump cardiac surgery using 10 predictors. The model showed good accuracy in predicting AKI severity and may be useful in clinical practice.
JOURNAL OF CLINICAL ANESTHESIA
(2022)
Article
Urology & Nephrology
Sidharth Kumar Sethi, Rajesh Sharma, Aditi Gupta, Abhishek Tibrewal, Romel Akole, Rohan Dhir, Kritika Soni, Shyam Bihari Bansal, Pranaw Kumar Jha, Anil Bhan, Vijay Kher, Rupesh Raina
Summary: This study aimed to establish long-term renal outcomes for pediatric patients after cardiac surgery, focusing on urinary biomarker abnormalities that persist years after surgery and may contribute to a low glomerular filtration rate during follow-up. The presence of AKI, AKI stage, and younger age were not associated with low GFR at follow-up, while children with a higher surgical complexity score tended to have lower GFR.
KIDNEY INTERNATIONAL REPORTS
(2021)
Article
Medicine, General & Internal
Sairah Sharif, Bohan Chen, Pamela Brewster, Tian Chen, Lance Dworkin, Rujun Gong
Summary: This study aims to investigate the efficacy of short term low dose lithium on CSA-AKI in human patients through renal function evaluation using creatinine and AKI biomarkers. The study compares the effects of lithium treatment and placebo treatment on kidney injury and renal function.
FRONTIERS IN MEDICINE
(2021)
Article
Critical Care Medicine
Christina Massoth, Alexander Zarbock, Melanie Meersch
Summary: The incidence of acute kidney injury (AKI) after cardiac surgery is high, with about 3% of patients requiring renal replacement therapy. According to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria, AKI is defined as a sudden deterioration of renal function, developing within a period of hours to days.
CRITICAL CARE CLINICS
(2021)
Review
Cardiac & Cardiovascular Systems
Hongbai Wang, Chaobin Zhang, Yinan Li, Yuan Jia, Su Yuan, Jianhui Wang, Fuxia Yan
Summary: This meta-analysis investigates the effect of dexmedetomidine infusion on the incidence of acute kidney injury (AKI) after cardiac surgery in pediatric patients. The results show that dexmedetomidine significantly reduces the postoperative incidence of AKI compared to placebo. However, the significant difference is only observed in pediatric patients receiving combination of intra- and postoperative dexmedetomidine infusion.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Shouqiang Zhu, Peng Lu, Zhenran Liu, Shaoyang Li, Peitong Li, Bingdi Wei, Jiayi Li, Yupei Wang
Summary: This study aimed to describe the longitudinal dynamic hemoglobin trajectories in patients undergoing cardiac surgery and explore their predictive value for AKI compared to traditional threshold values. The interaction of red blood cell transfusion was also investigated. The results showed three distinct hemoglobin trajectories, and patients in the highest and medium trajectory groups had significantly lower AKI risk.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)
Article
Surgery
Hsun-Yi Fu, Nai-Kuan Chou, Yih-Sharng Chen, Hsi-Yu Yu
Summary: This study found a high incidence of postoperative AKI in patients with pre-existing impaired renal function, which was associated with high preoperative serum creatinine levels and decreased CPB target temperature. AKI patients had higher hospital mortality and a worse two-year renal function evolution compared to non-AKI patients.
ASIAN JOURNAL OF SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Ahmed T. Mokhtar, Karthik Tennankore, Steve Doucette, Christine R. Herman
Summary: This study aimed to determine the predictors of postoperative AKI following nonemergent cardiac surgery in patients with variable preoperative eGFR levels, finding that a lower eGFR category was the strongest predictor of AKI. A practical scorecard was developed to assess the risk of AKI following nonemergent cardiac surgery.
JOURNAL OF CARDIAC SURGERY
(2021)
Article
Cardiac & Cardiovascular Systems
Nikolay O. Kamenshchikov, Yana J. Anfinogenova, Boris N. Kozlov, Yulia S. Svirko, Stanislav E. Pekarskiy, Vladimir V. Evtushenko, Vladimir A. Lugovsky, Vladimir M. Shipulin, Vladimir V. Lomivorotov, Yuriy K. Podoksenov
Summary: This study evaluated the effects of nitric oxide (NO) supplementation on the development of acute kidney injury (AKI) after cardiac surgery. The results showed that NO treatment during cardiopulmonary bypass (CPB) was associated with a lower incidence of AKI and higher urine output. There was also a decrease in urinary neutrophil gelatinase-associated lipocalin levels in the NO treatment group. Concentrations of NO metabolites were significantly increased in this group.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2022)
Review
Anesthesiology
Yu-qin Long, Xiao-mei Feng, Xi-sheng Shan, Qing-cal Chen, Zhengyuan Xia, Fu-hai Ji, Hong Liu, Ke Peng
Summary: This meta-analysis demonstrates that RIPC reduces the incidence of AKI after cardiac surgery. This renoprotective effect of RIPC is mainly evident during volatile only anesthesia, in non-high-risk patients, and when AKIN or KDIGO criteria used for AKI diagnosis.
ANESTHESIA AND ANALGESIA
(2022)
Article
Pharmacology & Pharmacy
Qiang Gao, Hsiao-Pei Mok, Hai-Long Qiu, Jianzheng Cen, Jimei Chen, Jian Zhuang
Summary: This study investigated the association between total epinephrine dosage during resuscitation and acute kidney injury after return of spontaneous circulation in patients with cardiac arrest. The results showed that a higher epinephrine dosage was associated with an increased incidence of acute kidney injury in adult patients with in-hospital cardiac arrest.
FRONTIERS IN PHARMACOLOGY
(2022)
Article
Anesthesiology
Mikael Barbu, Anders Hjarpe, Andreas Martinsson, Goran Dellgren, Sven-Erik Ricksten, Lukas Lannemyr, Aldina Pivodic, Amar Taha, Anders Jeppsson
Summary: This study found that longer CPB time and aortic clamp time, periods of compromised blood flow during aortic clamp time, and lower hematocrit were associated with the risk of postoperative AKI. These findings suggest that efforts should be made to minimize CPB and aortic clamp time and avoid compromised blood flow and low hematocrit during surgery.
ACTA ANAESTHESIOLOGICA SCANDINAVICA
(2023)
