This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Rosner, M. H. Articles by Okusa, M. D. Search for Related Content PubMed PubMed Citation Articles by Rosner, M. H. Articles by Okusa, M. D. Pubmed/NCBI databases Medline Plus Health Information Kidney Diseases Social Bookmarking                   What's this?

Analytic Reviews: Cardiac Surgery as a Cause of Acute Kidney Injury: Pathogenesis and Potential Therapies

Department of Internal Medicine, University of Virginia Health System, Charlottesville, Virginia, mhr9r{at}virginia.edu

Didier Portilla, MD

Division of Nephrology, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas

Mark D. Okusa, MD

Department of Internal Medicine, University of Virginia Health System, Charlottesville, Virginia

Cardiopulmonary bypass surgery occurs in nearly 1 million patients per year. Acute kidney injury requiring dialysis can occur in up to 1% of these patients. The development of acute kidney injury is associated with substantial morbidity and mortality independent of all other factors, and many patients are left dependent on dialysis therapies. The pathogenesis of acute kidney injury involves multiple pathways. Hemodynamic, inflammatory, and nephrotoxic factors are involved and overlap each other in leading to kidney injury. Clinical studies have identified risk factors for acute kidney injury that can be used to effectively determine the risk of acute kidney injury in patients undergoing bypass surgery. These high-risk patients can then be targeted for renal protective strategies. Thus far, no single strategy has conclusively demonstrated its ability to prevent renal injury post-bypass surgery. Novel anti-inflammatory agents are in development and offer hope as potential therapies.

Key Words: cardiopulmonary bypass surgery • acute kidney injury • therapy • anti-inflammatory

Journal of Intensive Care Medicine, Vol. 23, No. 1, 3-18 (2008)
DOI: 10.1177/0885066607309998


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?