Acute Kidney Injury in Major Surgery

Acute kidney injury (AKI) complicates the inpatient stay for up to 50% of patients undergoing major surgery and is associated with increased mortality, increased risk for chronic kidney disease, and much higher costs. Despite this high prevalence and cost, AKI remains among the most underdiagnosed postoperative complications. The onset of surgical stress provides a unique opportunity to study AKI and to use risk stratification to guide assessment and intervention to achieve these goals. Interventions to prevent AKI, mitigate the injury when AKI occurs, treat collateral damage on the rest of the body, and facilitate renal recovery in patients with established AKI are under active study in surgical patients. Imaging, biomarker, and clinical risk score techniques are offering the prospect for better management of the perioperative risks for AKI through improved assessment of the patient's renal reserve and susceptibility to …