Cole Sheela Pai
Anesthesiology, Perioperative and Pain Medicine, Stanford University, 300 Pasteur Dr, H3580, Stanford, CA 94305, USA.
Anesthesiol Clin. 2018 Dec;36(4):539-551. doi: 10.1016/j.anclin.2018.07.005. Epub 2018 Oct 12.
Perioperative acute kidney injury is associated with morbidity and mortality. Several definitions have been proposed, incorporating small changes of serum creatinine and urinary output reduction as diagnostic criteria. In the surgical patient, comorbidities, type and timing of surgery, and nephrotoxins are important. Patient comorbidities remain a significant risk factor. Urgent or emergent surgery and cardiac or transplantation procedures are associated with a higher risk of acute kidney injury. Nephrotoxic drugs, contrast dye, and diuretics worsen preexisting kidney dysfunction or act as an adjunctive insult to perioperative injury. This review includes preoperative, intraoperative, and postoperative issues that can be mitigated.
围手术期急性肾损伤与发病率和死亡率相关。已经提出了几种定义，将血清肌酐的微小变化和尿量减少纳入诊断标准。在外科患者中，合并症、手术类型和时间以及肾毒素很重要。患者的合并症仍然是一个重要的危险因素。急诊或紧急手术以及心脏或移植手术与急性肾损伤的较高风险相关。肾毒性药物、造影剂和利尿剂会使已有的肾功能障碍恶化，或作为围手术期损伤的附加损害因素。本综述包括术前、术中和术后可缓解的问题。
