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Future Directions in Optimizing Anesthesia to Reduce Perioperative Acute Kidney Injury
Bin Zeng1, Yinuo Liu2,3, Jiawei Xu4,5
1Department of Gastroenterology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China.
Background:
Perioperative acute kidney injury (AKI) is common in surgical patients and is associated with high morbidity and mortality. There are currently few options for AKI prevention and treatment. Due to its complex pathophysiology, there is no efficient medication therapy to stop the onset of the injury or repair the damage already done. Certain anesthetics, however, have been demonstrated to affect the risk of perioperative AKI in some studies. The impact of anesthetics on renal function is particularly important as it is closely related to the prognosis of patients. Some anesthetics can induce anti-inflammatory, anti-necrotic, and anti-apoptotic effects. Propofol, sevoflurane, and dexmedetomidine are a few examples of anesthetics that have protective association with AKI in the perioperative period.
Summary:
In this study, we reviewed the clinical characteristics, risk factors, and pathogenesis of AKI. Subsequently, the protective effects of various anesthetic agents against perioperative AKI and the latest research are introduced.
Key Message:
This work demonstrates that a thorough understanding of the reciprocal effects of anesthetic drugs and AKI is crucial for safe perioperative care and prognosis of patients. However, more complete mechanisms and pathophysiological processes still need to be further studied.
Insights
Certain anesthetics may protect against perioperative acute kidney injury (AKI). Understanding anesthetic effects on kidney function is vital for patient outcomes, though more research is needed to fully elucidate mechanisms.
Area of Science:
- Nephrology
- Anesthesiology
- Critical Care Medicine
Background:
- Perioperative acute kidney injury (AKI) is a significant clinical challenge with high morbidity and mortality.
- Current therapeutic options for preventing or treating AKI are limited due to its complex pathophysiology.
- Anesthetic agents are increasingly recognized for their potential influence on perioperative renal outcomes.
Purpose of the Study:
- To review the clinical characteristics, risk factors, and pathogenesis of AKI.
- To introduce the protective effects of various anesthetic agents against perioperative AKI.
- To highlight the latest research on anesthetics and renal protection.
Main Methods:
- Literature review of clinical studies and research on perioperative AKI.
- Analysis of anesthetic agents' impact on renal function and patient prognosis.
- Synthesis of current understanding regarding anesthetic-induced renal protection.
Main Results:
- Certain anesthetics demonstrate protective associations with perioperative AKI.
- Anesthetics can exert anti-inflammatory, anti-necrotic, and anti-apoptotic effects on the kidneys.
- Propofol, sevoflurane, and dexmedetomidine are examples of anesthetics with potential renal protective properties.
Conclusions:
- A comprehensive understanding of the interplay between anesthetic drugs and AKI is crucial for optimizing perioperative care.
- Further research is necessary to fully elucidate the mechanisms and pathophysiological processes involved in anesthetic-induced renal protection.
- Investigating anesthetic effects on kidney function can improve patient prognosis in surgical settings.
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