Acute Kidney Injury After Cardiac Surgery

Abstract

Acute kidney injury (AKI), a recognized complication of cardiac surgery with cardiopulmonary bypass (CPB) is associated with increased morbidity and mortality (15-30%) with approximately 1% of all the affected patients requiring dialysis.

AKI-CS has a poor prognosis with the mortality ranging from 10-80% (uncomplicated AKI - 10% AKI with multi-organ failure >50%, AKI requiring renal replacement therapy - 80%). Risk Factors Are patient releated such as Age, Sex, Reduced LV function and procedure releated such as type of surgery and its duration. Patho-mechanisms Likely to involve the following mechanisms, processes, factors, and pathways: Toxins, Metabolic factors, Ischemia-reperfusion, Neurohormonal activation, Inflammation and Oxidative stress. And typically classified according to their timely occurrence into:-Pre-operative, intra-operative and post-operative events.