Acute kidney injury in open abdominal aortic aneurysm repair (literature review)

Acute kidney injury is the most common complication after open abdominal aortic aneurysm repair, thus significantly deteriorating the postoperative period. Traditionally, preoperative and intraoperative factors are considered as risk factors for the development of acute kidney injury. Intraoperative risk factors are recognized by many authors as determining factors in the development of this complication after abdominal aortic aneurysm repair. To date, there is no scientifically based strategy for the prevention of acute renal dysfunction in open abdominal aortic surgery that would reduce the risk of this complication. This article presents a review of Russian and foreign literature dedicated to acute kidney injury after open abdominal aortic aneurysm repair. The modern classifications of this complication, as well as the evolution of their formation are given. The main preoperative and intraoperative risk factors for the development of acute kidney injury are considered in detail. It is noted that in many studies factors of surgical and anesthesiologic 'aggression' were the most significant in influencing postoperative renal function. Clinical guidelines, systematic reviews and meta-analyses regarding the prevention of acute kidney injury after open abdominal aortic aneurysm repair were analyzed in detail. It was concluded that at present there is no sustainable strategy for preventing this complication after open surgery, with most protective procedures performed empirically.