Table 2.
Risk factors for acute kidney injury
| Preoperative | Intraoperative |
| Patient related | Patient related |
| Renal dysfunction/high SCr1 | Low venous compliance |
| Advanced age | Low systemic vascular resistance |
| Female gender | Autoregulatory systems disturbances |
| NYHA FC IV Reduced LVEF or CHF | Low output syndrome (pressor/IABP need) |
| Left main CAD | Type of surgery |
| Diabetes mellitus | Valvular |
| Poor glycemic control | Re do surgery |
| Peripheral vascular disease | Emergency |
| COPD | |
| Coexisting liver disease | |
| Preoperative IABP | |
| Pulmonary rales | |
| Genetic predisposition | |
| Modifiable | Procedure related3 |
| Extremes of SBP2 | On-pump cardiac surgery |
| Sepsis2 | Nonpulsatile flow on CPB |
| Medications (NSAID, ARB) | Hypothermic CPB |
| Contrast dye | Deep hypothermic circulatory arrest |
| Duration of CPB (> 100-120 min) | |
| Perfusion pressure | |
| Hemodilution during CPB | |
| Blood transfusion | |
| Hemolysis | |
| Embolism |
1
Risk factors with higher level of evidence are in bold;
2
both patient related and modifiable;
3
and also modifiable. NYHA FC IV: New York Heart Association Function class IV; LVEF: Left ventricle ejection fraction; CHF: Congestive heart failure; CAD: Coronary artery disease; COPD: Chronic obstructive pulmonary disease; IABP: Intra-aortic balloon pump; SBP: Systolic blood pressure; NSAID: Nonsteroidal anti-inflammatory drug; ARB: Angiotensin receptor blockers; CPB: Cardiopulmonary bypass; SCr: Serum creatinine.