Prevention of Cardiac Surgery-Associated Acute Kidney Injury: A Review of Current Strategies

Anesthesiol Clin. 2019 Dec;37(4):729-749. doi: 10.1016/j.anclin.2019.08.007. Epub 2019 Sep 21.


Acute kidney injury is a common and often severe postoperative complication after cardiac surgery, and is associated with poor short-term and long-term outcomes. Numerous randomized controlled trials have been conducted to investigate various strategies for prevention of cardiac surgery-associated acute kidney injury. Unfortunately, most trials that have been conducted to date have been negative. However, encouraging results have been demonstrated with preoperative administration of corticosteroids, leukocyte filtration, and administration of inhaled nitric oxide intraoperatively, and implementation of a Kidney Disease: Improving Global Outcomes bundle of care approach postoperatively. These findings require validation in large, multicenter trials.

Keywords: Acute kidney injury; Cardiac surgery; Inflammation; Perioperative care; Prevention; Randomized controlled trial.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / etiology*
  • Acute Kidney Injury / prevention & control
  • Acute Kidney Injury / therapy*
  • Cardiac Surgical Procedures / adverse effects*
  • Humans
  • Postoperative Complications / prevention & control
  • Randomized Controlled Trials as Topic