Perioperative Acute Kidney Injury

  • Sam D. Gumbert
    From the Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas (S.D.G., M.L.J., N.V., S.J.G., C.Y.W., H.K.E.); and the Department of Anesthesiology, Rheinisch-Westfälische Technische Hochschule Aachen University, Aachen, Germany (F.K.).
  • Felix Kork
    From the Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas (S.D.G., M.L.J., N.V., S.J.G., C.Y.W., H.K.E.); and the Department of Anesthesiology, Rheinisch-Westfälische Technische Hochschule Aachen University, Aachen, Germany (F.K.).
  • Maisie L. Jackson
    From the Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas (S.D.G., M.L.J., N.V., S.J.G., C.Y.W., H.K.E.); and the Department of Anesthesiology, Rheinisch-Westfälische Technische Hochschule Aachen University, Aachen, Germany (F.K.).
  • Naveen Vanga
    From the Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas (S.D.G., M.L.J., N.V., S.J.G., C.Y.W., H.K.E.); and the Department of Anesthesiology, Rheinisch-Westfälische Technische Hochschule Aachen University, Aachen, Germany (F.K.).
  • Semhar J. Ghebremichael
    From the Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas (S.D.G., M.L.J., N.V., S.J.G., C.Y.W., H.K.E.); and the Department of Anesthesiology, Rheinisch-Westfälische Technische Hochschule Aachen University, Aachen, Germany (F.K.).
  • Christy Y. Wang
    From the Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas (S.D.G., M.L.J., N.V., S.J.G., C.Y.W., H.K.E.); and the Department of Anesthesiology, Rheinisch-Westfälische Technische Hochschule Aachen University, Aachen, Germany (F.K.).
  • Holger K. Eltzschig
    From the Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas (S.D.G., M.L.J., N.V., S.J.G., C.Y.W., H.K.E.); and the Department of Anesthesiology, Rheinisch-Westfälische Technische Hochschule Aachen University, Aachen, Germany (F.K.).

説明

<jats:title>Abstract</jats:title> <jats:p>Perioperative organ injury is among the leading causes of morbidity and mortality of surgical patients. Among different types of perioperative organ injury, acute kidney injury occurs particularly frequently and has an exceptionally detrimental effect on surgical outcomes. Currently, acute kidney injury is most commonly diagnosed by assessing increases in serum creatinine concentration or decreased urine output. Recently, novel biomarkers have become a focus of translational research for improving timely detection and prognosis for acute kidney injury. However, specificity and timing of biomarker release continue to present challenges to their integration into existing diagnostic regimens. Despite many clinical trials using various pharmacologic or nonpharmacologic interventions, reliable means to prevent or reverse acute kidney injury are still lacking. Nevertheless, several recent randomized multicenter trials provide new insights into renal replacement strategies, composition of intravenous fluid replacement, goal-directed fluid therapy, or remote ischemic preconditioning in their impact on perioperative acute kidney injury. This review provides an update on the latest progress toward the understanding of disease mechanism, diagnosis, and managing perioperative acute kidney injury, as well as highlights areas of ongoing research efforts for preventing and treating acute kidney injury in surgical patients.</jats:p>

収録刊行物

  • Anesthesiology

    Anesthesiology 132 (1), 180-204, 2020-01-01

    Ovid Technologies (Wolters Kluwer Health)

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