Acute kidney injury after cardiac surgery.

IF 2.3 3区医学 Q2 ANESTHESIOLOGY Current Opinion in Anesthesiology Pub Date : 2024-02-01 Epub Date: 2023-10-05 DOI:10.1097/ACO.0000000000001320

Thilo von Groote, Mahan Sadjadi, Alexander Zarbock

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Abstract

Purpose of review: Patients undergoing cardiac surgery are at high risk to develop cardiac surgery-associated acute kidney injury (CS-AKI) postoperatively. CS-AKI is associated with an increased risk for persistent renal dysfunction, morbidity and mortality. This review summarizes the epidemiology and pathophysiology of CS-AKI, as well as current treatment and prevention strategies.

Recent findings: As AKI is a syndrome with complex pathophysiology, no causative treatment strategies exist. Recent advances in the field of AKI biomarkers offer new perspectives on the issue and the implementation of biomarker-guided preventive strategies may reduce rates of CS-AKI. Finally, nephroprotective treatments and angiotensin II as a novel vasopressor may offer new opportunities for high-risk patients undergoing cardiac surgery.

Summary: Based on the described novel approaches for early detection, prevention and management of CS-AKI, a precision-medicine approach should be implemented in order to prevent the development of AKI in patients undergoing cardiac surgery.

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心脏手术后急性肾损伤。

综述目的：接受心脏手术的患者术后发生心脏手术相关急性肾损伤（CS-AKI）的风险很高。CS-AKI与持续性肾功能障碍、发病率和死亡率的风险增加有关。本文综述了CS-AKI的流行病学和病理生理学，以及目前的治疗和预防策略。最近的发现：由于AKI是一种具有复杂病理生理学的综合征，目前尚无病因治疗策略。AKI生物标志物领域的最新进展为这一问题提供了新的视角，实施生物标志物指导的预防策略可能会降低CS-AKI的发病率。最后，肾保护性治疗和血管紧张素II作为一种新型血管升压药可能为接受心脏手术的高危患者提供新的机会。总结：基于所描述的CS-AKI早期检测、预防和管理的新方法，应实施精确医学方法，以防止心脏手术患者发生AKI。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Anesthesiology 医学-麻醉学

CiteScore

4.90

自引率

8.00%

发文量

207

审稿时长

12 months

期刊介绍： Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Anesthesiology features hand-picked review articles from our team of expert editors. With fifteen disciplines published across the year – including cardiovascular anesthesiology, neuroanesthesia and pain medicine – every issue also contains annotated references detailing the merits of the most important papers.

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