The Effect of Intraoperative Hypotension on Postoperative Renal Function

Area of Science:

• Anesthesiology
• Nephrology
• Critical Care Medicine

Background:

• Intraoperative hypotension (IOH) is increasingly recognized as a significant risk factor for adverse postoperative outcomes.
• Recent retrospective studies highlight a robust association between IOH and postoperative acute kidney injury (AKI).
• IOH is also implicated in other serious complications, including myocardial infarction, stroke, and mortality.

Purpose of the Study:

• To review the current literature on the association between IOH and postoperative AKI.
• To provide evidence-based recommendations for intraoperative blood pressure management aimed at reducing AKI incidence.
• To briefly discuss fluid management, vasopressor use, and other strategies for AKI prevention.

Main Methods:

• Literature review of recent studies.
• Analysis of associations between intraoperative blood pressure and postoperative complications.
• Synthesis of recommendations for clinical practice.

Main Results:

• A strong association exists between IOH and the development of postoperative AKI.
• Maintaining intraoperative mean blood pressure above 65 mmHg is recommended to mitigate AKI risk.
• IOH is linked to a higher incidence of myocardial infarction, stroke, and death.

Conclusions:

• Intraoperative hypotension is a critical factor contributing to postoperative AKI.
• Strict adherence to blood pressure targets during surgery is essential for patient safety.
• While blood pressure management is key, the multifactorial etiology of AKI necessitates consideration of other contributing factors for comprehensive prevention.