Acute kidney injury in perioperative settings

Acute kidney injury is a clinical syndrome which represents relevant and serious perioperative complication. It is associated with increased patient morbidity, mortality, prolonged hospital stays, and not to mention greater healthcare costs. Yet, the patients who suffered from temporary acute kidney injury in the perioperative period, and regardless of the final outcome, usually complain afterwards about emotional distress, coupled with poor quality of life associated with loss of energy and limited normal physical activity. Therefore, the role of the physician to predict a kidney vulnerable patient in the perioperative period is a task of great importance, albeit not an easy one. The key management is risk stratification of the patient in conjunction with hemodynamic and oxygen optimization, in addition to avoiding nephrotoxic agents during the entire perioperative period.