Features  |   November 2015
Perioperative Kidney Injury: An Overlooked Complication?
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Renal and Urinary Systems / Electrolyte Balance / Trauma / Burn Care / Features
Features   |   November 2015
Perioperative Kidney Injury: An Overlooked Complication?
ASA Monitor 11 2015, Vol.79, 16-18.
ASA Monitor 11 2015, Vol.79, 16-18.
Classification: Perioperative acute kidney injury (AKI) was previously known as “acute renal failure.” To facilitate its management, standardized classification of severity of AKI is utilized. Two sets of criteria are popular for classification of AKI by serum creatinine (Scr) and urine output. The RIFLE classification includes graded severity of injury: (R)isk, (I)njury, (F)ailure; and adverse outcome-(L)oss, (E)nd-stage renal disease. Classes 1, 2 and 3 of the AKIN (Acute Kidney Injury Network) classification are similar to RIF: Scr increase by 50 percent, 100 percent and 200 percent.
Incidence: AKI is more common and morbid than often appreciated. Its reported incidence during cardiac surgery is 30 percent.1  After major non-cardiac surgery, the incidence is reported to be 6.3 percent.2  In another study, during non-cardiac, non-vascular surgery, the incidence of AKI was 6.7 percent.3  Incidence of AKI during abdominal surgery is reported to be 1.1 percent.4  It was 3.5 percent in exploratory laparotomy patients, who had greater acuity.4  The incidence of AKI is high in septic patients, critically ill patients and major trauma patients.
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