Premium
Peri‐operative renal dysfunction: prevention and management
Author(s) -
Golden D.,
Corbett J.,
Forni L. G.
Publication year - 2016
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.13313
Subject(s) - medicine , acute kidney injury , renal replacement therapy , nephrotoxicity , kidney disease , urinary system , intensive care medicine , creatinine , antibiotics , perioperative , kidney , intensive care , surgery , microbiology and biotechnology , biology
Summary Postoperative increases in serum creatinine concentration, by amounts historically viewed as trivial, are associated with increased morbidity and mortality. Acute kidney injury is common, affecting one in five patients admitted with acute medical disease and up to four in five patients admitted to intensive care, of whom one in two have had operations. This review is focused principally on the identification of patients at risk of acute kidney injury and the prevention of injury. In the main, there are no interventions that directly treat the damaged kidney. The management of acute kidney injury is based on correction of dehydration, hypotension, and urinary tract obstruction, stopping nephrotoxic drugs, giving antibiotics for bacterial infection, and commencing renal replacement therapy if necessary.