Postoperative renal dysfunction after noncardiac surgery

Suvi T. Vaara, Rinaldo Bellomo

Research output: Contribution to journalReview ArticleResearchpeer-review

14 Citations (Scopus)

Abstract

Purpose of review The narrative review aims to discuss recent results and important knowledge gaps regarding acute kidney injury (AKI) in postoperative patients undergone major noncardiac surgery. Recent findings Postoperative AKI affects approximately one-fifth of patients after major surgery, but the incidence varies according to the type of surgery. Preexisting chronic kidney disease is a major risk factor for postoperative AKI. It carries a substantial risk for postoperative adverse outcomes, as well as long-term mortality and morbidity. To prevent postoperative AKI, avoiding intraoperative hypotension and hypoperfusion as well as nephrotoxic substances are important. Currently, no efficient pharmacotherapy for prevention or treatment of AKI is available. In general, goal-directed management protocols have reduced the incidence of postoperative AKI. Additionally, a restrictive fluid management regimen might reduce organ edema and be beneficial also for the kidney function. Summary AKI is a frequent postoperative complication with a substantial risk for both short and long-term adverse events, and its incidence is likely to rise because of increasing major surgical procedures. Studies investigating better strategies to prevent and treat AKI in this population are urgently needed.

Original languageEnglish
Pages (from-to)440-446
Number of pages7
JournalCurrent Opinion in Critical Care
Volume23
Issue number5
DOIs
Publication statusPublished - Oct 2017
Externally publishedYes

Keywords

  • acute kidney injury
  • epidemiology
  • postoperative
  • prevention

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