Cardiac surgery-associated acute kidney injury: a contemporary approach to the problem

A prevalence of cardiac surgery-associated acute kidney injury (CSA-AKI) is even up to 30% in the early post-operative course. A mortality rate in patients with this complication is as much as 5-fold higher than in those free from CSA-AKI. Great hopes for an improvement of CSA-AKI patients’ outcomes can be pinned on a wider use of renal replacement therapy (RRT). The biggest challenge for today is to establish the standards of early implementation of RRT because further reliance on such parameters as plasma creatinine level or urinary output seems to be inadequate. The number of substances determined either in plasma or in urine has been investigated as potential biomarkers of AKI. The most promising are cystatin C, neutrophil gelatinase-associated lipocalin (NGAL), interleukin 18 (IL-18) and kidney injury molecule-1 (KIM-1). Nevertheless, the occurrence of CSA-AKI is associated with significant prognosis deterioration, lengthening of the hospitalization period and increasing treatment costs.