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Renal complications of anaesthesia

McKinlay, J., Tyson, E. and Forni, L. G. (2018) Renal complications of anaesthesia Anaesthesia, 73. pp. 85-94.

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Peri‐operative acute kidney injury is common, accounting for 30–40% of all in‐hospital cases of acute kidney injury. It is associated with clinically significant morbidity and mortality even with what was hitherto regarded as relatively trivial increases in serum creatinine, and carries over a 12‐fold relative risk of death following major abdominal surgery. Comorbid conditions such as diabetes, hypertension, liver disease and particularly pre‐existing chronic kidney disease, as well as the type and urgency of surgery, are major risk factors for the development of postoperative acute kidney injury. As yet, there are no specific treatment options for the injured kidney, although there are several modifiable risk factors of which the anaesthetist should be aware. As well as the avoidance of potential nephrotoxins and appropriate volume balance, optimal anaesthetic management should aim to reduce the risk of postoperative renal complications. This may include careful ventilatory management and blood pressure control, as well as appropriate analgesic strategies. The choice of anaesthetic agent may also influence renal outcomes. Rather than concentrate on the classical management of acute kidney injury, this review focuses on the potential development of acute kidney injury peri‐operatively, and the means by which this may be ameliorated.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine
Authors :
McKinlay, J.
Tyson, E.
Forni, L.
Date : 3 January 2018
DOI : 10.1111/anae.14144
Copyright Disclaimer : © 2018 The Association of Anaesthetists of Great Britain and Ireland
Uncontrolled Keywords : Acute kidney injury (AKI); Risk factors; Peri-operative management; Nephrotoxins
Depositing User : Diane Maxfield
Date Deposited : 25 Oct 2019 09:38
Last Modified : 25 Oct 2019 09:38

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