Acute kidney injury and postoperative delirium

Postoperative acute kidney injury (AKI) and postoperative delirium (POD) are two of the most common complications after surgery. It is essential to understand their common mechanisms not only to prevent and predict the occurrence of these complications, but also to guide perioperative management and improve surgical outcomes. This review summarizes the recent literature focused on these postoperative complications and explores the relationship between AKI and POD. Numerous clinical studies have used AKI and POD as primary outcomes and have found that AKI and POD often occur simultaneously in the perioperative period in susceptible groups undergoing major surgery. Some research findings indicate that the brain and the kidney exhibit bidirectional communication that is affected by systemic inflammation, drug accumulation, uremic toxins, vascular endothelial injury, and fluid volume redistribution during the perioperative period. AKI and POD share common mechanisms involving a variety of complex physiological and pathological pathways, leading to impairment of renal and cerebral function.