Table 1.
Risk factors for the development of ARF in common clinical situations
| Post-operative (general) | Cardiac surgery | Critically ill | Sepsis | Contrast nephropathy | Nephrotoxic antibiotics |
|---|---|---|---|---|---|
| Cardiac | Female gender | Active cancer | S bilirubin >1.5 mg/dL | Systolic BP <80 mmHg for >1 hr | Amphotericin |
| Haemodynamic | ACE inhibitor therapy | Low-serum | Age | and need for inotropic support | Volume depletion |
| instability | Heart failure | albumin | SCr >1.3 mg/dL | or IABP 24 h after procedure | Concurrent other |
| Congestive heart failure | LV ejection fraction < | A-a gradient* | Elevated CVP >8 cm | Use of IABP | nephropathy |
| Aortic cross clamping | 35% | H2O under fluid | Heart failure (NYHA class 3–4), | Aminoglycosides | |
| Major vascular surgery | Preoperative IABP | substitution for | history of pulmonary oedema, or | Duration of >7 d | |
| Hypertension | COPD | haemodynamic | both | Volume depletion | |
| Infection | Insulin-requiring diabetes | instability | Age >75 yrs | Divided dose | |
| Sepsis | Previous cardiac surgery | Hct: <39% for ?; <36% for ? | regimens | ||
| Multi-organ failure | Emergency surgery | Diabetes mellitus | Sepsis | ||
| Gastrointestinal and | Valve surgery only | Volume of contrast >100 mL | Liver disease | ||
| endocrine | Combination of CABG | SCr >1.5 mg/dL or eGFR < | Old age | ||
| Cirrhosis | +valve surgery | 60 mL/min/1.73 m2 | Pre-existing CKD | ||
| Biliary surgery | Other cardiac surgery | Intra-arterial injection | |||
| Obstructive jaundice | Preoperative SCr > | ||||
| Diabetes mellitus | 2.1 mg/dL | ||||
| Renal Transplantation | |||||
| Oliguria < 400 mL/day | |||||
| SCr > 2 mg/dL | |||||
| Miscellaneous | |||||
| Age > 70 years | |||||
| Trauma | |||||
| Massive blood | |||||
| transfusion |
CABG—coronary arterial bypass graft.
CVP—central venous pressure.
IABP: intra-aortic balloon pump.
COPD: chronic obstructive pulmonary disease.
Hct: haematocrit.
*A- a gradient: alveolar-arterial oxygen gradient calculated using the sea level standard formula [(713 × (FiO2)−(PCO2/0.8)−PaO2], where FiO2: fractional inspired oxygen concentration, PaO2: arterial partial oxygen pressure, PCO2: partial CO2 pressure. The normal A-a gradient varies with age and ranges from 7 to 14 mmHg when breathing room air.
Modified from Modified from ref. [7].