Strategies to Reduce Perioperative Nephrotoxicity

Semin Nephrol. 2019 Sep;39(5):442-453. doi: 10.1016/j.semnephrol.2019.06.004.

Abstract

Postoperative acute kidney injury (AKI) is a common complication of surgery that is associated with significant adverse outcomes, including increased morbidity and mortality. The perioperative burden of AKI risk factors is complex and potentially large, including high-risk nephrotoxic medications, hypotension, hypovolemia, radiologic contrast, anemia, and surgery-specific factors. Understanding the pathogenesis, risk factors, and potential cumulative impact of perioperative nephrotoxic exposures is particularly important in the prevention and reduction of perioperative AKI. This review outlines the possible strategies to reduce perioperative nephrotoxicity and the development of postoperative AKI.

Keywords: Perioperative; acute kidney injury; nephrotoxicity; surgery.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / prevention & control*
  • Hemodynamics / drug effects
  • Humans
  • Hypotension / complications
  • Hypovolemia / complications
  • Kidney / blood supply
  • Kidney / drug effects
  • Models, Statistical
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control*
  • Practice Guidelines as Topic
  • Risk Assessment
  • Risk Factors