Predicting and preventing acute kidney injury after cardiac surgery

Purpose of review Acute kidney injury (AKI) after cardiac surgery is associated with significant morbidity and mortality. Despite the proliferation of predictive clinical scoring models of renal risk after cardiac surgery, limitations in preventing AKI through the use of pharmacological agents remain. Here we review the evolution of predictive models of renal risk after cardiac surgery, and highlight the important gains made in preventing its occurrence. Recent findings Simple risk indices predicting AKI after cardiac surgery have been developed and can now be readily applied clinically. However, studies focusing on preventing AKI after surgery have yet to demonstrate any consistent renoprotective effect. Summary Clinical scoring systems predicting AKI risk after cardiac surgery are available and should be employed in the preoperative assessment. Elucidation of beneficial preventive strategies of AKI after cardiac surgery requires ongoing research.