Best Practice & Research Clinical Anaesthesiology
Volume 22, Issue 1 , Pages 193-208, March 2008

Perioperative renal protection☆

  • Dean R. Jones, M.D., FRCPC (Assistant Professor)
    • ,
  • H. Thomas Lee, M.D., Ph.D. (Assistant Professor)

      Affiliations

    • Corresponding Author InformationCorresponding author. H. Thomas Lee, M.D., Ph.D., Assistant Professor, Department of Anesthesiology, Anesthesiology Research Laboratories, Columbia University, P&S Box 46 (PH-5), 630 West 168th Street, New York, NY 10032-3784, USA. Tel.: +1 212 305 1807; Fax: +1 212 305 8980.

Department of Anesthesiology, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA

Acute kidney injury (AKI) is a significant cause of perioperative patient morbidity and mortality. The definition of AKI has recently changed and further research is underway to identify clinically relevant biomarkers to aid in the diagnosis of the syndrome. AKI is often multi-factorial in origin and patients with certain preoperative risk factors are at elevated risk of perioperative AKI. An anesthesiologist's main objective for perioperative renal protection is prevention by maintenance of euvolemia, preservation of adequate renal perfusion, and avoidance of nephrotoxins. This review will address the definition and diagnosis of AKI, identify patients at risk of AKI, and critically appraise management options for perioperative renal protection.

Key words: acute kidney injury, acute renal failure, biomarkers, renal protection, fenoldopam

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☆ This work was supported solely by the Intramural Research Fund of the Department of Anesthesiology at Columbia University.

PII: S1521-6896(07)00080-8

doi:10.1016/j.bpa.2007.08.005

Best Practice & Research Clinical Anaesthesiology
Volume 22, Issue 1 , Pages 193-208, March 2008

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