01734nas a2200229   4500000000100000008004100001260001600042653001100058653001400069653003000083653002400113653003200137653003100169653003200200100001200232700002000244245009700264300001200361490000700373520111000380022001401490       2017                            d  c3133211098610aHumans10aPrognosis10aRenal Replacement Therapy10aAcute Kidney Injury10aPostoperative Complications10aGlomerular Filtration Rate10aCardiac Surgical Procedures1 aWang Y.1 aBellomo Rinaldo00aCardiac surgery-associated acute kidney injury: risk factors, pathophysiology and treatment.  a697-7110 v133 a<p>
Cardiac surgery-associated acute kidney injury (CSA-AKI) is the most common clinically important complication in adult patients undergoing open heart surgery, and is associated with increased mortality and morbidity. In patients in intensive care units, CSA-AKI is the second most common type of AKI after septic AKI. In this Review, we explore the definition of CSA-AKI, discuss its epidemiology and identify its risk factors. We discuss current theories of the pathophysiology of CSA-AKI and describe its clinical course. Furthermore, we introduce diagnostic tools with particular reference to novel biomarkers of AKI and their potential utility; we analyse currently applied interventions aimed at attenuating AKI in patients undergoing cardiac surgery; and describe evidence from randomized controlled trials aimed at preventing or treating CSA-AKI. Finally, we explore issues in the use of renal replacement therapy, its timing, its intensity and its preferred modalities in patients with CSA-AKI, and we discuss the prognosis of CSA-AKI in terms of patient survival and kidney recovery.
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