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16 - Effects of Perioperative Management on Kidney Function

from Section 2 - Targeting Effects

Published online by Cambridge University Press:  03 December 2019

By
Xavier Borrat  and
Jordi Mercadal
Edited by
Pedro L. Gambús  and
Jan F. A. Hendrickx
Pedro L. Gambús
Affiliation:
Hospital Clinic de Barcelona, Spain
Jan F. A. Hendrickx
Affiliation:
Aalst General Hospital, Belgium
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Summary

Normal kidney function is essential to maintain whole body homeostasis. An acute decline in kidney function, ‘acute kidney injury’ (AKI), is in and by itself a major cause of perioperative morbidity and mortality. Maintaining preexisting kidney function therefore is a key task of the anaesthesiologist in the perioperative period [1].

Studies on perioperative AKI (including worsening of chronic renal failure) have mainly focused on the postoperative/ICU setting because (1) renal dysfunction does not alter intraoperative haemodynamics or oxygenation (provided a neutral fluid balance is maintained); (2) we lack readily available biomarkers to monitor intraoperative renal function (intraoperative oliguria is a poor marker of AKI, and creatinine value takes hours to rise); (3) medical treatment of AKI is mainly performed in the ICU (managing fluid overload, hyperkalaemia, drug dosing adjustments or renal replacement therapies); (4) patients at risk for AKI are likely to be admitted to the ICU postoperatively.

Type
Chapter
Information
Personalized Anaesthesia
Targeting Physiological Systems for Optimal Effect
 , pp. 238 - 244
Publisher: Cambridge University Press
Print publication year: 2020

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References

Bartels, K, Karhausen, J, Clambey, ET, Grenz, A, Eltzschig, HK: Perioperative organ injury. Anesthesiology. 2013; 119: 1474–89.CrossRefGoogle ScholarPubMed
Bellomo, R, Ronco, C, Kellum, JA, Mehta, RL, Palevsky, P: Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit.Care 2004; 8: R204–12.Google Scholar
Susantitaphong, P, Cruz, DN, Cerda, J, Abulfaraj, M, Alqahtani, F, Koulouridis, I, Jaber, BL: World incidence of AKI: a meta-analysis. Clin.J.Am.Soc.Nephrol. 2013; 8: 1482–93.CrossRefGoogle ScholarPubMed
Goren, O, Matot, I: Perioperative acute kidney injury. Br.J.Anaesth. 2015; 115 Suppl 2: ii3–14.Google Scholar
Prowle, JR, Liu, Y-L, Licari, E, Bagshaw, SM, Egi, M, Haase, M, Haase-Fielitz, A, Kellum, JA, Cruz, D, Ronco, C, Tsutsui, K, Uchino, S, Bellomo, R: Oliguria as predictive biomarker of acute kidney injury in critically ill patients. Crit.Care 2011; 15: R172.Google Scholar
Kheterpal, S, Tremper, KK, Englesbe, MJ, O’Reilly, M, Shanks, AM, Fetterman, DM, Rosenberg, AL, Swartz, RD: Predictors of postoperative acute renal failure after noncardiac surgery in patients with previously normal renal function. Anesthesiology. 2007; 107: 892–902.Google Scholar
Novis, BK, Roizen, MF, Aronson, S, Thisted, RA: Association of preoperative risk factors with postoperative acute renal failure. Anesth.Analg. 1994; 78: 143–9.CrossRefGoogle ScholarPubMed
Lote, CJ: Renal blood flow and glomerular filtration rate. In Lote, CJ, Principles of Renal Physiology. New York, NY: Springer, 2013: 83–92.Google Scholar
Bellomo, R, Giantomasso, DD: Noradrenaline and the kidney: friends or foes? Crit.Care. 2001; 5: 294–8.Google Scholar
Marik, PE: Iatrogenic salt water drowning and the hazards of a high central venous pressure. Ann.Intens.Care. 2014; 4: 21.CrossRefGoogle ScholarPubMed
Hoste, EAJ, Bagshaw, SM, Bellomo, R, Cely, CM, Colman, R, Cruz, DN, et al.: Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intens.Care.Med. 2015; 41: 1411–23.CrossRefGoogle Scholar
Prowle, J, Bagshaw, SM, Bellomo, R: Renal blood flow, fractional excretion of sodium and acute kidney injury: time for a new paradigm? Curr.Opin.Crit.Care. 2012; 18: 585–92.CrossRefGoogle ScholarPubMed
Schneider, AG, Bellomo, R: Urinalysis and pre-renal acute kidney injury: time to move on. Crit.Care. 2013; 17: 141.CrossRefGoogle ScholarPubMed
Sharfuddin, A, Molitoris, B: Pathophysiology of ischemic acute kidney injury. Nat.Rev.Nephrol. 2011; 7: 189–200.CrossRefGoogle ScholarPubMed
Prowle, JR, Kirwan, CJ, Bellomo, R: Fluid management for the prevention and attenuation of acute kidney injury. Nat.Rev.Nephrol. 2014; 10: 37–47.CrossRefGoogle ScholarPubMed
Prowle, JR, Echeverri, JE, Ligabo, EV, Ronco, C, Bellomo, R: Fluid balance and acute kidney injury. Nat.Rev.Nephrol. 2009; 6: 107–15.Google ScholarPubMed
Myles, PS, Bellomo, R, Corcoran, T, Forbes, A, Peyton, P, et al: Restrictive versus liberal fluid therapy for major abdominal surgery. N.Engl.J.Med. 201; 378: 2263–74.Google Scholar
Ostermann, M, Joannidis, M: Acute kidney injury 2016: diagnosis and diagnostic workup. Crit.Care 2016; 20: 299.Google Scholar
Uchino, S, Kellum, JA, Bellomo, R, Doig, GS, Morimatsu, H, Morgera, S, Schetz, M, Tan, I, Bouman, C, Macedo, E, Gibney, N, Tolwani, A, Ronco, C: Acute renal failure in critically ill patients. J.Am.Med.Assoc. 2005; 294: 813–18.Google Scholar
Langenberg, C, Bellomo, R, May, C, Wan, L, Egi, M, Morgera, S. Renal blood flow in sepsis. Crit.Care 2005; 9: R363–74.CrossRefGoogle ScholarPubMed
Murugan, R, Karajala-Subramanyam, V, Lee, M, Yende, S, Kong, L, Carter, M, Angus, DC, Kellum, JA: Genetic and inflammatory markers of sepsis (GenIMS) investigators. Acute kidney injury in non-severe pneumonia is associated with an increased immune response and lower survival. Kidney.Int. 2010; 77: 527–35.CrossRefGoogle ScholarPubMed
Langenberg, C, Bagshaw, SM, May, CN, Bellomo, R: The histopathology of septic acute kidney injury: a systematic review. Crit.Care 2008; 12: R38.Google Scholar
Gomez, H, Ince, C, De Backer, D, Pickkers, P, Payen, D, Hotchkiss, J, Kellum, J: A unified theory of sepsis-induced acute kidney injury. Shock. 2014; 41: 3–11.Google Scholar
Joannidis, M, Druml, W, Forni, LG, Groeneveld, ABJ, Honore, P, Oudemans-van Straaten, HM, Ronco, C, Schetz, MRC, Woittiez, AJ: Prevention of acute kidney injury and protection of renal function in the intensive care unit. Expert opinion of the Working Group for Nephrology, ESICM. Intens.Care.Med. 2010; 36: 392–411.CrossRefGoogle Scholar
Legrand, M, Dupuis, C, Simon, C, Gayat, E, Mateo, J, Lukaszewicz, AC, Payen, D: Association between systemic hemodynamics and septic acute kidney injury in critically ill patients: a retrospective observational study. Crit.Care 2013; 17: R278.Google Scholar
Group KDIGO (KDIGO) AKIW. KDIGO clinical practice guideline for acute kidney injury. Kidney.Inter. 2012; 2: 1–138.Google Scholar
Sutherland, SM, Chawla, LS, Kane-Gill, SL, Hsu, RK, Kramer, AA, Goldstein, SL, Kellum, JA, Ronco, C, Bagshaw, SM: Utilizing electronic health records to predict acute kidney injury risk and outcomes: workgroup statements from the 15(th) ADQI Consensus Conference. Can.J.Kidney.Heal.Dis. 2016; 3: 11.Google Scholar
Chertow, GM, Burdick, E, Honour, M, Bonventre, J V, Bates, DW: Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J.Am.Soc.Nephrol. 2005; 16: 3365–70.Google Scholar

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