Epidemiology, outcomes, and management of acute kidney injury in the vascular surgery patient

摘要: Abstract Objective Conventional clinical wisdom has often been nihilistic regarding the prevention and management of acute kidney injury (AKI), despite its being a frequent morbid complication associated with both increased mortality cost. Recent developments have shown that AKI is not inevitable changes in patients can reduce incidence morbidity perioperative AKI. The purpose this narrative review was to epidemiology outcomes undergoing vascular surgery using current consensus definitions, discuss some novel emerging risk stratification techniques relevant patient, describe standardized pathway for after surgery. Methods We performed critical literature on patient PubMed MEDLINE databases Google Scholar through September 2017 web-based search engines. also searched guidelines publications available online from organizations Kidney Disease: Improving Global Outcomes Acute Dialysis Quality Initiative. terms used included injury, AKI, epidemiology, outcomes, prevention, therapy, treatment. Results reported evolving since publication criteria allow accurate identification mild moderate major as high 49%, although there are significant differences, depending type procedure performed. Many tools become assess stratify use information prevent surgical patient. assessment patients, incorporating preventive strategies decrease complications. Patients without any factors be managed fast-track pathway. Those positive tested stress urinary biomarker TIMP-2•IGFBP7, care is then stratified according result. Management follows guidelines. Conclusions common postoperative among impact morbidity, mortality, Preoperative optimal guided by minimize consequences Adherence designed offers promising approach mitigate severity challenging problem.