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European Heart Journal 1989 10(Supplement H):38-42; doi:10.1093/eurheartj/10.suppl_H.38
Copyright © 1989 by the European Society of Cardiology.
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© 1989 The European Society of Cardiology

Acute renal failure after cardiovascular surgery. Current concepts in pathophysiology, prevention and treatment

P. B. Leurs, A. W. Mulder, H. A. Fiers and S. J. Hoorntje

Department of Internal Medicine, Catharina Hospital Eindhoven, The Netherlands

Address for correspondence: A. W. Mulder, Department of Internal Medicine, Catharina Hospital, P.O. Box 1350, 5602 ZA Michelangelolaan 2 Eindhoven, The Netherlands

Acute renal failure (ARF) is a serious complication of cardiovascular surgery and has a high mortality rate, especially with oliguria. It is usually caused by ischaemic injury of the kidney, resulting from inadequate perfusion. Certain risk factors which might lead to the development of ARF following open heart operations have been identified: age >70 years; elevated pre-operative serum creatinine; low blood pressure during cardiopulmonary bypass; rate of haemolysis; a postoperative critical circulation.

It is necessary to establish the diagnosis as soon as possible in order to institute corrective measures to prevent oliguric ARF. Once renal failure is established close control of hydration, solutes and potentially toxic metabolites is necessary. Early renal replacement therapy with proper nutritional support appears to improve survival.

Key Words: Acute renal failure • open heart surgery • dialytic techniques


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