الفهرس 
Etiology and epidemiology of acute kidney injury following cardiac surgery with cardiopulmonary bypassOnly 14 pages are availabe for public view
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Abstract
A
cute kidney injury following cardiac surgery with cardiopulmonary bypass is a common clinical problem which is associated with poor outcomes.
The incidence of sustaining acute kidney injury (AKI) requiring dialysis following cardiac surgery varies greatly by procedure up to 5% of patients develop renal failure requiring dialysis following cardiac surgery.
Early identification of patients at risk for AKI-CPB is an important strategy to better care for patients during the postoperative period.
The conduct of CPB during cardiac surgery may affect the incidence of post-operative ARF. Limiting the duration of CPB and maintaining adequate flow and perfusion pressure are of primary importance.
Hypothermia during CPB has conventionally been used for organ protection through reduction of metabolic activity and amelioration of ischemic stress. Nevertheless, few studies have demonstrated that the use of normothermia may yield comparable, if not improved, clinical outcomes in CABG.
The pathophysiology of postoperative AKI in cardiac surgery is resulting from a combination vascular and tubular injury. During cardiopulmonary bypass (CPB), the kidneys are exposed to interruptions and alterations in blood flow due to changes in pump flow and the lack of pulsatility, which can lead to ischemia-reperfusion injury.
Pharmacological strategies that increase renal blood flow or decrease renal oxygen consumption have not proved successful. Despite extensive investigation, few drug interventions have been demonstrated to provide clinical benefit and some have been clearly shown to be ineffective.
In AKI, serum creatinine is a poor diagnostic marker for AKI & not a real time indicator of kidney function this raised the importance of the novel biomarkers including neutrophil gelatinase-associated lipocalin (NGAL) cystatin C (CyC) kidney injury molecule-1 (KIM-1) and interleukin-18 (IL-18).
The provision of renal replacement therapy (RRT) in patients with acute kidney injury (AKI) is extremely variable and based primarily on empiricism and local institutional practice and resources. In particular, No recommendations can be made on mode and timing of beginning and ending of RRT in AKI after cardiovascular surgery.