Table 2.
Analysis of risk factors for perioperative AKI.
| Risk factors | Details of contents | ||
|---|---|---|---|
| Impaired clinical status | Age ≥ 56 years, male, active congestive heart failure, ascites, hypertension, preoperative creatinine > 106 mol/L, diabetes mellitus (controlled by either oral medication or insulin injections), ventilator dependence, chronic obstructive pulmonary disease, smoking, coagulation disorders, cancer, obesity, and long-term steroid use | ||
| Drugs that may impair kidney function | Non-steroidal anti-inflammatory drugs | Selective COX-2 inhibitors have relatively few adverse effects on the kidney | (28, 29) |
| No significant difference in the risk of kidney injury between COX-2 inhibitors and non-selective COX inhibitors | (30) | ||
| NSAIDS can cause drug-induced acute interstitial nephritis (AIN) | (31–33) | ||
| ACEI and ARB | Perioperative treatment with ACEI/ARB increases the incidence of postoperative AKI | (34–36) | |
| Absolute risk of perioperative AKI reduced with ACEI/ARB | (37) | ||
| Antibiotics | Aminoglycosides can cause renal tubular toxicity | (38) | |
| Vancomycin is most likely to produce nephrotoxicity through increased reactive oxygen species and oxidative stress | (39) | ||
| Fluoroquinolones were graded in order of nephrotoxicity as ciprofloxacin, moxifloxacin and levofloxacin fluoroquinolones can cause AIN | (40, 41) | ||
| High-dose cephalosporin treatment causes proximal tubular necrosis and renal insufficiency in rats | (42) | ||
| Intravenous (arterial) injection of contrast media | The prevalence of CI-AKI is 2% in the general population but increases to 20–40% in high-risk patients | (43) | |
| There was no significant difference in the incidence of AKI between the contrast and control groups | (44) | ||
| Intra-arterial contrast injection is more nephrotoxic than intravenous use | (45) | ||
| No significant difference in AKI incidence with vs. without PCI in STEMI patients | (46) | ||
| Special surgical interventions | Heart surgery | Higher incidence of AKI after heart valve surgery with increased subsequent dialysis dependence and in-hospital mortality | (47) |
| Liver transplantation | The incidence of perioperative AKI is high, and the occurrence and progression of AKI affect the short-term and long-term survival of the graft | (48) | |
| Abdominal aortic aneurysm surgery | The operation can increase the risk of perioperative AKI | (49) | |
| Severity of postoperative AKI after open repair is independently associated with increased in-hospital mortality in patients with postoperative AKI | (50) | ||
| Pulmonary endarterectomy | The incidence of postoperative AKI is higher in patients with chronic thromboembolic pulmonary hypertension | (51) | |
| Anesthesia | Anesthesia method | Intraoperative MAP consistently <60 mmHg for 20 min and <55 mmHg for 10 min increased the incidence of postoperative AKI | (52) |
| Reduced risk of renal failure in patients treated with intraspinal anesthesia compared to general anesthesia | (53) | ||
| Narcotic drugs | Sevoflurane anesthesia reduces kidney injury in small volume liver transplant rats | (54) | |
| Higher incidence of AKI in patients with sevoflurane than in those receiving propofol | (55) | ||
| Propofol preserves the morphological integrity of the kidney and attenuates AKI in mice undergoing cecum ligation and puncture surgery | (56) | ||
| Anemia and the effects of blood transfusion | Anemia | Reduced perioperative hemoglobin concentration is strongly associated with the development of postoperative AKI | (57) |
| Blood transfusion | Increased risk of perioperative AKI is directly proportional to the number of red blood cell infusions | (58–60) | |
| Malnutrition | Perioperative nutritional status of patients is closely related to the occurrence of AKI | (61–65) | |
| Hyperglycemia | Hyperglycemia is considered one of the independent predictors of increased mortality and worsened prognosis in perioperative patients | (5) | |