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Reviews in Cardiovascular Medicine  2020, Vol. 21 Issue (4): 601-610     DOI: 10.31083/j.rcm.2020.04.206
Systematic Review Previous articles | Next articles
Determinants of acute kidney injury after cardiac surgery: a systematic review
Grigore Tinica1, 2, , Crischentian Brinza1, 2, , Adrian Covic2, 3, Iolanda Valentina Popa2, *(), Andrei Tarus1, 2, Alberto Emanuel Bacusca1, 2, Alexandru Burlacu2, 4
1Department of Cardiovascular Surgery, Cardiovascular Diseases Institute, 700503, Iasi, Romania
2 'Grigore T. Popa', University of Medicine, 700115, Iasi, Romania
3Nephrology Clinic, Dialysis, and Renal Transplant Center, 'C.I. Parhon' Hospital, 700507, Iasi, Romania
4Department of Interventional Cardiology, Cardiovascular Diseases Institute, 700503, Iasi, Romania
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Acute kidney injury following cardiac surgery (CS-AKI) represents a severe postoperative complication, negatively impacting short-term and long-term mortality. Due to the lack of a specific treatment, effective prevention remains the most powerful tool to overcome the CS-AKI burden. Improving the preventive strategies is possible by establishing appropriate preoperative risk profiles. Various clinical models were proposed as a means to assist physicians in stratifying the risk of CS-AKI. However, these models are used for predicting severe forms of CS-AKI, while their predictive power for mild forms is insufficient. Our paper represents the first systematic approach to review all proposed preoperative risk factors and their predictive power. Our strategy is the starting point for selecting and comparing the predictive elements to be integrated into future risk models. Heart failure, chronic hyperglycemia, anemia, obesity, preoperative exposure to nephrotoxic drugs or contrast media, inflammation, proteinuria, and pre-existing kidney disease were systematically reviewed and were found to be associated with an increased risk of postoperative CS-AKI. As no externally validated and universally accepted risk models currently exist, the clinical judgment and a good knowledge of the preoperative risk factors in the light of new evidence may help personalize preoperative risk profiles as the cornerstone of prevention measures.
Key words:  Acute kidney injury      cardiac surgery      risk factors      risk prediction      risk stratification models     
Submitted:  10 October 2020      Revised:  26 October 2020      Accepted:  03 November 2020      Published:  30 December 2020     
*Corresponding Author(s):  Iolanda Valentina Popa     E-mail:
About author:  These authors contributed equally.

Cite this article: 

Grigore Tinica, Crischentian Brinza, Adrian Covic, Iolanda Valentina Popa, Andrei Tarus, Alberto Emanuel Bacusca, Alexandru Burlacu. Determinants of acute kidney injury after cardiac surgery: a systematic review. Reviews in Cardiovascular Medicine, 2020, 21(4): 601-610.

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