Cardiac surgery–associated acute kidney injury: from oxygen delivery and renal medullary hypoxia to precision cardiorenal monitoring

A.A. Khakimov, D.D. Olimjonov, Guzal Mullabayeva

Zamonaviy tibbiyot jurnali / Journal of modern medicine · 2026-yil

Annotatsiya

Cardiac surgery–associated acute kidney injury (CSA-AKI) complicates 20–50% of procedures requiring cardiopulmonary bypass (CPB), independently increasing perioperative mortality threefold to fivefold, triggering progression to chronic kidney disease (CKD) in 25–30% of surviving cohorts, and generating substantial long-term cardiovascular burden. This narrative review systematises the pathophysiology, biomarker landscape, and evidence-based preventive strategies of CSA-AKI, with emphasis on the critical threshold of indexed oxygen delivery (DO₂I) below 272 mL/min/m² inducing systemic dysoxia; ischaemia–reperfusion cascades and endothelial glycocalyx collapse; neutrophil gelatinase-associated lipocalin (NGAL) providing early structural signals within 2–6 hours post-CPB (AUC 0.78–0.85 in adults); [TIMP-2]×[IGFBP7] identifying G₁ cell-cycle arrest stress (AUC 0.80, SAPPHIRE trial); and preoperative urinary DKK3 reflecting baseline renal vulnerability (OR 5.27, Lancet 2019). Goal-directed perfusion maintaining DO₂I above 272 mL/min/m² significantly reduces CSA-AKI incidence (RR 0.71, 95% CI 0.56–0.90). Biomarker-guided KDIGO care bundle implementation was validated in PrevAKI RCTs. A structured literature search was conducted across PubMed, Scopus, and Web of Science (January 2005 – March 2026); 41 references verified by DOI or URL were selected from over 310 initially screened publications.

Maqola ma’lumotlari
MualliflarA.A. Khakimov, D.D. Olimjonov, Guzal Mullabayeva
JurnalZamonaviy tibbiyot jurnali / Journal of modern medicine
NashriyotАндижон давлат тиббиёт институти
ISSN2992-8958
Nashr sanasi2026-07-10
Jild14
Son3
Betlar161-170
TilIngliz
Ilmiy sohaTibbiyot
DOI10.67519/nshr.ztj.2026.03.033
Indeksga qo‘shilgan2026-09-02

DOI: 10.67519/nshr.ztj.2026.03.033 · Maqolaning asl sahifasi · PDF

Ilmiy soha

Tibbiyot

Iqtibos keltirish

APAA.A. Khakimov, D.D. Olimjonov, & Guzal Mullabayeva (2026). CARDIAC SURGERY–ASSOCIATED ACUTE KIDNEY INJURY: FROM OXYGEN DELIVERY AND RENAL MEDULLARY HYPOXIA TO PRECISION CARDIORENAL MONITORING. Zamonaviy tibbiyot jurnali / Journal of modern medicine, 14(3), 161-170. https://doi.org/10.67519/nshr.ztj.2026.03.033
GOST (OAK)A.A. Khakimov, D.D. Olimjonov, Guzal Mullabayeva CARDIAC SURGERY–ASSOCIATED ACUTE KIDNEY INJURY: FROM OXYGEN DELIVERY AND RENAL MEDULLARY HYPOXIA TO PRECISION CARDIORENAL MONITORING // Zamonaviy tibbiyot jurnali / Journal of modern medicine. – 2026. – T. 14, № 3. – P. 161-170. – DOI: 10.67519/nshr.ztj.2026.03.033.
MLAA.A. Khakimov, D.D. Olimjonov, and Guzal Mullabayeva. “CARDIAC SURGERY–ASSOCIATED ACUTE KIDNEY INJURY: FROM OXYGEN DELIVERY AND RENAL MEDULLARY HYPOXIA TO PRECISION CARDIORENAL MONITORING.” Zamonaviy tibbiyot jurnali / Journal of modern medicine, 14(3), 161-170, 2026. https://doi.org/10.67519/nshr.ztj.2026.03.033
ChicagoA.A. Khakimov, D.D. Olimjonov, and Guzal Mullabayeva. “CARDIAC SURGERY–ASSOCIATED ACUTE KIDNEY INJURY: FROM OXYGEN DELIVERY AND RENAL MEDULLARY HYPOXIA TO PRECISION CARDIORENAL MONITORING.” Zamonaviy tibbiyot jurnali / Journal of modern medicine, 14(3), 161-170 (2026). https://doi.org/10.67519/nshr.ztj.2026.03.033
HarvardA.A. Khakimov, D.D. Olimjonov, and Guzal Mullabayeva (2026) ‘CARDIAC SURGERY–ASSOCIATED ACUTE KIDNEY INJURY: FROM OXYGEN DELIVERY AND RENAL MEDULLARY HYPOXIA TO PRECISION CARDIORENAL MONITORING’, Zamonaviy tibbiyot jurnali / Journal of modern medicine, 14(3), 161-170. https://doi.org/10.67519/nshr.ztj.2026.03.033
BibTeX
@article{aakhakimov2026,
  title = {CARDIAC SURGERY–ASSOCIATED ACUTE KIDNEY INJURY: FROM OXYGEN DELIVERY AND RENAL MEDULLARY HYPOXIA TO PRECISION CARDIORENAL MONITORING},
  author = {A.A. Khakimov and D.D. Olimjonov and Guzal Mullabayeva},
  journal = {Zamonaviy tibbiyot jurnali / Journal of modern medicine},
  year = {2026},
  volume = {14},
  number = {3},
  pages = {161-170},
  doi = {10.67519/nshr.ztj.2026.03.033},
  url = {https://doi.org/10.67519/nshr.ztj.2026.03.033}
}

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