Early Prediction and Management of Acute Kidney Injury Post Coronary Artery Bypass Surgery
ALI MOHAMED HUSSEIN;
Abstract
SUMMARY
T
he impact of the degree of renal dysfunction (RD) in patients after going coronary artery bypass grafting (CABG) ranges from normal to dialysis-dependence. It is well established that the presence and progression of cardiovascular disease and chronic kidney disease are often intimately associated.
Acute kidney injury (AKI) designates the condition previously called acute renal failure and represents a spectrum of renal diseases varying from minor elevations of serum creatinine to anuric renal failure .So a new classification system for AKI was introduced in 2004 named RIFLE(Risk, Injury, Failure, Loss, and End stage) to provide a standardized definition of AKI. Since then, the RIFLE classification has been validated and widely accepted.
The RIFLE classification defines 3 grades of AKI severity (RIFLE-R, risk; RIFLE-I, injury; and RIFLE-F, failure) based on changes in serum creatinine relative to the baseline condition.
There are Various factors found to be associated with the development of AKI after surgery. Preoperative correlations include advanced age, baseline renal dysfunction, female gender, chronic obstructive pulmonary disease, diabetes, peripheral vascular disease, congestive heart failure, left ventricular ejection fraction less than 35%, cardiogenic shock, need for emergency surgery, and left main coronary artery disease. Intraoperative correlations include cardiopulmonary bypass, and aortic cross clamp time. Post operative correlations include ongoing hemodynamic alterations, high vasopressor requirements, mechanical circulatory support devices (e.g., IABP, VAD).
T
he impact of the degree of renal dysfunction (RD) in patients after going coronary artery bypass grafting (CABG) ranges from normal to dialysis-dependence. It is well established that the presence and progression of cardiovascular disease and chronic kidney disease are often intimately associated.
Acute kidney injury (AKI) designates the condition previously called acute renal failure and represents a spectrum of renal diseases varying from minor elevations of serum creatinine to anuric renal failure .So a new classification system for AKI was introduced in 2004 named RIFLE(Risk, Injury, Failure, Loss, and End stage) to provide a standardized definition of AKI. Since then, the RIFLE classification has been validated and widely accepted.
The RIFLE classification defines 3 grades of AKI severity (RIFLE-R, risk; RIFLE-I, injury; and RIFLE-F, failure) based on changes in serum creatinine relative to the baseline condition.
There are Various factors found to be associated with the development of AKI after surgery. Preoperative correlations include advanced age, baseline renal dysfunction, female gender, chronic obstructive pulmonary disease, diabetes, peripheral vascular disease, congestive heart failure, left ventricular ejection fraction less than 35%, cardiogenic shock, need for emergency surgery, and left main coronary artery disease. Intraoperative correlations include cardiopulmonary bypass, and aortic cross clamp time. Post operative correlations include ongoing hemodynamic alterations, high vasopressor requirements, mechanical circulatory support devices (e.g., IABP, VAD).
Other data
| Title | Early Prediction and Management of Acute Kidney Injury Post Coronary Artery Bypass Surgery | Other Titles | التنبؤ المبكر وكيفية التعامل مع القصور الكلوي الحاد ما بعد زراعه الشرايين التاجية | Authors | ALI MOHAMED HUSSEIN | Issue Date | 2017 |
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