Table 2.
Pathophysiologic factors contributing to development of ARF (3).
| Preoperative | Intraoperative | Postoperative |
|---|---|---|
| Lack of renal reserve | Decreased renal perfusion | Systemic inflammation |
| Renovascular disease | Hypotension | Reduced LV function |
| Prerenal azotemia | Lack of pulsatile flow | Vasoactive agents |
| Recent diuresis | Vasoactive agents | Hemodynamic instability |
| NPO status | Anesthetic effects | Nephrotoxins |
| Impaired LV function | Embolic events | Volume depletion |
| ACEI/ARB | CPB-induced inflammation | Sepsis |
| Nephrotoxins | Nephrotoxins | |
| Intravenous contrast | Free hemoglobin | |
| Other medications | ||
| Endotoxemia | ||
| Inflammation |
NPO, nothing by mouth.
Republished with permission from Clin J Am Soc Nephrol 2006:1:19–3.