Epidemiology of post-operative AKI
Charuhas Thakar, MD (University of Cincinnati)
Dr. Thakar started of a great session by putting AKI in proper perspective. A full 1/3 of all hospitalized acute kidney injury (AKI) patients develop AKI in the operative setting (per the BEST data). Whether the patient is in the MICU or SICU, 80% of AKI patients usually have stage 1 AKI (Thakar C, CCM 2009). As it turns out, neurosurgical patients have the lowest risk of all surgical patients to develop AKI; Cardiothoracic patients have the most. The key elements for *recovering* from AKI include: 1) the time of AKI onset, 2) the severity of the AKI (as measured by the peak serum Cr), and 3) the duration of the AKI. Each of these 3 elements have been shown, in studies, to impact the likelihood of renal recovery.
Dr. Thakar mentioned some of the risk factors for developing AKI. Asides from the standard risks, such as older age, presence of diabetes and/or hypertension, he also mentioned hyperglycemia, on-pump cardiac bypass, and degree of proteinuria at baseline.