ACUTE KIDNEY INJURY AFTER CARDIAC SURGERY
Acute kidney injury (AKI) is a common complication which is witnessed after cardiac surgery and is associated with high morbidity and mortality. AKI develops in 50% of patients who undergone cardiothoracic surgery and it injures and impairs the function of vital organs such as lungs, brain, digestive tract and increases 5-8 fold risk of the fatality during hospitalization. Renal ischemia, hemolysis, inflammation, reperfusion, oxidative stress, cholesterol emboli and toxins contribute to the development of AKI. Strategies to prevent from AKI are limited according to diverse etiology but some evidence supports of renal perfusion and maintenance of intravascular volume, administration of balance salt or limitation of cardio-pulmonary bypass reduce AKI. In AKI renal replacement therapy is demanded in 5-9% of patients after cardiac surgery and is followed 50% mortality. As long as AKI is observed in a mild or moderate stage, patient's condition does not require renal replacement therapy, but chronic kidney disease develops gradually ensuing month or year. Time-sensitive and efficient methods to identify AKI, reduce negative short and long term outcomes. The discovery and validation of new renal damage biomarkers give opportunity to diagnose AKI during 12-24 hours after the injury.