Management of patients with acute kidney injury as part of the multiple organ dysfunction syndrome after open heart surgery

Authors: Yarustovskiy M.B., Abramyan M.V., Begachev A.V., NazarovN.S., Nazarova E.I., Mironenko V.A., Tsaloeva A.P.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Clinical Cases


DOI: https://doi.org/10.24022/1997-3187-2023-17-4-544-553

For citation: Yarustovskiy M.B., Abramyan M.V., Begachev A.V., Nazarov N.S., Nazarova E.I., Mironenko V.A., TsaloevaA.P. Management of patients with acute kidney injury as part of the multiple organ dysfunction syndrome after open heart surgery. Creative Cardiology. 2023; 17 (4): 544–53 (in Russ.). DOI: 10.24022/1997-3187-2023-17-4-544-553

Received / Accepted:  18.08.2023 / 03.11.2023

Keywords: cardiac surgery renal replacement therapy acute kidney injury glomerular filtration rate kinetic glomerular filtration rate



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Abstract

In cardiac surgery practice, renal dysfunction quite often complicates the course of both the underlying disease of the heart and blood vessels, and the postoperative period. With the appearance of the first signs of the development of acute kidney injury (AKI), changes in the level of creatinine in the blood serum should be monitored in order to form a protocol for the clinical management of the patient, up to the need for a transition to intensive care with the possible connection of renal replacement therapy methods. In routine practice, renal function is assessed by estimated creatinine clearance or glomerular filtration rate (GFR), which have limitations for intensive care: they are only valid when the patient is stable. We used a formula for the dynamic assessment of glomerular filtration rate – kinetic GFR (KeGFR). This indicator makes it possible to analyze the prognosis and course of acute kidney pathology and determine the protocol for managing these patients in the complex of ongoing intensive care.

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About Authors

  • Mikhail B. Yarustovskiy, Dr. Med. Sci., Professor, Corresponding Member of RAS, Deputy Director, Head of Department;ORCID
  • Marina V. Abramyan, Cand. Med. Sci., Leading Researcher, Transfusiologist; ORCID
  • Aleksey V. Begachev, Junior Researcher, Anesthesiologist-Intensivist; ORCID
  • Nikita S. Nazarov, Cand. Med. Sci., Senior Researcher, Endoscopist; ORCID
  • Elena I. Nazarova, Transfusiologist; ORCID
  • Vladimir A. Mironenko, Dr. Med. Sci., Head of Department; ORCID
  • Anna P. Tsaloeva, Junior Researcher, Surgeon;

    Chief Editor

    Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery




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