High-volume hydration for the prevention of acute kidney injury after cardiac surgery

Acute kidney injury (AKI) is a serious complication after cardiac surgery, occurring between 5% to 30% of patients, according to the used definition (1-16). In 6% to 20% of patients experiencing AKI, dialysis is required (11,12). Development of AKI leads to an increase in mortality, both at short- and long-term follow-up (1-18). In particular, it has been showed that 12% to 64% of patients experiencing AKI die, as compared to 1% to 5% of patients not developing AKI (11-15). This mortality risk increases also with minor serum creatinine elevations, exceeding 50% in cases requiring hemodialysis (15). Moreover, AKI has a critical impact on non-renal morbidity, as it is associated after cardiac surgery with a higher rate of respiratory insufficiency, infections, sepsis, and gastrointestinal bleeding (1-12).