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Direct Drug Delivery to Kidney via the Renal Artery
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Perioperative renal protection.

Emmanuel Canet1,2, Rinaldo Bellomo1,2,3,4

  • 1Department of Intensive Care, Austin Hospital, Heidelberg.

Current Opinion in Critical Care
|October 12, 2018
PubMed
Summary
This summary is machine-generated.

Perioperative acute kidney injury (AKI) affects 1 in 10 surgical patients. Personalized, multicomponent strategies focusing on hemodynamic management and novel biomarkers show promise in reducing AKI risk and improving patient outcomes.

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Area of Science:

  • Nephrology
  • Critical Care Medicine
  • Surgical Outcomes

Background:

  • Perioperative acute kidney injury (AKI) is a significant complication, affecting approximately 10% of surgical patients.
  • Cardiac, orthopedic, and major abdominal surgeries present the highest risk.
  • Procedure-related factors like complex operations, bleeding, and hemodynamic instability are key contributors to AKI.

Purpose of the Study:

  • To review recent literature on perioperative acute kidney injury (AKI).
  • To highlight current understanding of risk factors, biomarkers, and management strategies for AKI.
  • To discuss emerging approaches for reducing AKI incidence and improving patient outcomes.

Main Methods:

  • Literature review of recent studies on perioperative acute kidney injury.
  • Analysis of risk factors, diagnostic biomarkers, and therapeutic interventions.
  • Synthesis of findings related to hemodynamic management and novel renoprotective agents.

Main Results:

  • Cell cycle arrest biomarkers show potential for identifying high-risk patients.
  • Protocol-based hemodynamic management, including personalized blood pressure targets, can reduce AKI.
  • Emerging renoprotective agents (angiotensin II, nitric oxide) and urinary oxygenation monitoring warrant further investigation.

Conclusions:

  • Acute kidney injury (AKI) is a common and severe postoperative complication.
  • A personalized, multicomponent approach to patient management is crucial for mitigating AKI risk.
  • Optimizing hemodynamic status and exploring novel therapeutic strategies are key to improving outcomes for surgical patients at risk of AKI.