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Updated: Apr 9, 2026

Intravascular Delivery of Biologics to the Rat Kidney
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Novel therapy for renal protection.

Alexander Zarbock1, Kindgen Milles

  • 1aDepartment of Anesthesiology, Intensive Care, and Pain Medicine, University of Münster, Münster bDepartment of Anesthesiology and Intensive Care Medicine, University Hospital, Heinrich-Heine University of Düsseldorf, Düsseldorf, Germany.

Current Opinion in Anaesthesiology
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PubMed
Summary

Preventing acute kidney injury (AKI) after surgery requires early risk identification and improved perioperative management. Strategies include hemodynamic stabilization, balanced fluids, and avoiding nephrotoxic drugs to protect kidney function.

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Area of Science:

  • Nephrology
  • Surgical Complications
  • Critical Care Medicine

Background:

  • Acute kidney injury (AKI) is a significant post-surgical complication, increasing morbidity, mortality, and healthcare costs.
  • Effective strategies for renal protection and AKI prevention in the perioperative setting are crucial.

Purpose of the Study:

  • To review recent studies on strategies for renal protection.
  • To discuss the prevention of acute kidney injury after surgical procedures.

Main Methods:

  • Review of recent scientific literature on perioperative renal protection.
  • Analysis of studies on biomarkers, fluid therapy, sedatives, and hemodynamic management.

Main Results:

  • Early identification of at-risk patients using novel biomarkers is key for timely intervention.
  • Balanced crystalloid fluids and avoidance of hyperchloremic solutions reduce AKI incidence.
  • Aggressive hemodynamic stabilization is the most effective intervention for AKI prevention; dexmedetomidine shows preliminary protective effects.

Conclusions:

  • Early identification of patients susceptible to AKI is critical for implementing protective measures.
  • Optimized perioperative management, including hemodynamic stabilization and avoiding nephrotoxic agents, is essential for AKI prevention.
  • While pharmacological therapies are under investigation, current critical interventions focus on hemodynamic optimization and judicious drug selection.