Adult Cardiac Surgery-Associated Acute Kidney Injury: Joint Consensus Report

Objectives: Acute kidney injury (AKI) is increasingly recognized as a source of poor patient outcomes after cardiac surgery. The purpose of the present report is to provide perioperative teams with expert recommendations specific to cardiac surgery associated AKI (CSA-AKI). Methods: This report and consensus recommendations were developed during a joint, in-person, multidisciplinary conference with the Perioperative Quality Initiative and the Enhanced Recovery After Surgery Cardiac Society. Multinational practitioners with diverse expertise in all aspects of cardiac surgical perioperative care, including clinical backgrounds in anesthesiology, surgery and nursing, met from October 20 to 22, 2021, in Sacramento, California, and used a modified Delphi process and a comprehensive review of evidence to formulate recommendations. The quality of evidence and strength of each recommendation were established using the Grading of Recommendations Assessment, Development, and Evaluation methodology. A majority vote endorsed recommendations. Results: Based on available evidence and group consensus, a total of 13 recommendations were formulated (4 for the preoperative phase, 4 for the intraoperative phase, and 5 for the postoperative phase), and are reported here.

Automated summary

This report provides expert recommendations for improving patient outcomes in cardiac surgery-associated acute kidney injury (CSA-AKI). A total of 13 recommendations, covering the preoperative, intraoperative, and postoperative phases, were formulated based on a multidisciplinary conference and comprehensive evidence review.