Acute renal insufficiency is a challenging problem after cardiac surgery

Abstract

Acute renal failure (ARF) refers to the abrupt loss of kidney function. There are many possible causes of acute renal failure categorized into three major areas prerenal, intrarenal, and postrenal. Acute kidney injury following major cardiovascular surgery has a complex and multifactorial etiology which includes pre-operative renal insufficiency, advanced age, history of congestive heart failure, diabetes mellitus, recent exposure to nephrotoxic agents such as contrast dye, intra-aortic balloon pump, emergency operation, prolonged cardiopulmonary bypass (CPB) time, low urinary output during CPB, and need for deep hypothermic circulatory arrest. The twentieth international consensus conference of acute disease quality initiative group found that acute kidney injury is a common perioperative complication for patients undergoing cardiovascular surgery. When renal failure after cardiac surgery is severe enough to require renal replacement therapy, the mortality rate is close to 60%. The successful prevention and management of acute kidney injury involves identifying patients at risk for acute kidney injury, recognizing subtle abnormalities in a timely manner, performing basic clinical assessments and responding appropriately to the data obtained. Objectives: To find the main risk factors of renal failure after cardiac surgery, to find the possibilities to reduce the risk of renal failure in the patient undergoing elective cardiac surgery Prepare a plan for reducing the risk of renal insufficiency in the patient undergoing elective cardiac surgery. Methods. For this research, the literature search was conducted in the PubMed, Medline updates from web sites, library data base, science direct and 30 literature sources where reviewed. Studies published in English between 2009–2019 have been reviewed. Results. 56 years old white male patient arrived for elective cardiac surgery due to coronary artery disease. He comp[...].