Prevention and management of acute kidney injury in the perioperative patient

Abstract

Acute kidney injury should be regarded as a medical emergency and a biomarker of acute illness. It is detected by rises in serum creatinine or reductions in urine output and is a common and costly surgical complication, increasing length of stay, perioperative morbidity and mortality. Imperative to improving outcomes of patients with AKI is recognition of patients at risk, with the institution of preventative measures and the prompt treatment of those developing AKI. There are new therapies in the pipeline for AKI but in the interim the effectiveness of the application of a simple AKI care bundle should not be underestimated. The STOP AKI approach is centred on promoting better recognition of four key pillars in the management of AKI. These include treatment of Sepsis, stopping and avoiding Toxins, Optimization of blood pressure and fluid status and review Prescribing to include the treatment of complications.