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.
| Mualliflar | A.A. Khakimov, D.D. Olimjonov, Guzal Mullabayeva |
|---|---|
| Jurnal | Zamonaviy tibbiyot jurnali / Journal of modern medicine |
| Nashr sanasi | 2026-07-10 |
| Jild | 14 |
| Son | 3 |
| Betlar | 161-170 |
| Til | en |
| DOI | 10.67519/nshr.ztj.2026.03.033 |
DOI: 10.67519/nshr.ztj.2026.03.033 · Maqolaning asl sahifasi · PDF
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