Abstract:Cardiac surgery-associated acute kidney injury (CSA-AKI) is a frequent and serious complication after cardiac surgery, as it significantly increases the mortality rate and worsens long-term clinical outcomes. Early identification of high-risk patients and timely preventive intervention are critical for improving prognosis. This article reviews cardiac surgery-associated acute kidney injury (CSA-AKI), briefly summarizes its epidemiological characteristics.; clarifies the diagnostic criteria of the Kidney Disease: Improving Global Outcomes (KDIGO) and the newly added diagnostic dimension of subclinical acute kidney injury; elaborates on the core pathophysiological mechanisms including intraoperative renal hypoperfusion, ischemia-reperfusion injury, systemic inflammatory response, and microcirculatory disturbance; classifies risk factors throughout the perioperative period (preoperative, intraoperative and postoperative) and further distinguishes between controllable and uncontrollable factors; summarizes the clinical application status, advantages and disadvantages of novel biomarkers covering renal injury and functional types such as cystatin C, interleukin-18 and neutrophil gelatinase-associated lipocalin, as well as clinical evaluation tools capable of dynamically monitoring renal perfusion and oxygenation including renal resistive index, urinary partial pressure of oxygen and renal near-infrared spectroscopy; and also summarizes the whole-process perioperative prevention and management strategies. This review aims to provide a reference for the clinical diagnosis, treatment and subsequent research of CSA-AKI.
