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Postoperatives Nierenversagen

Postoperative renal failure

  • Leitthema
  • Published:
Der Nephrologe Aims and scope

Zusammenfassung

Ein wesentlicher Anteil aller akuten intrahospitalen Nierenfunktionsstörungen tritt in der postoperativen Phase auf. Das postoperative Nierenversagen geht mit einer verlängerten Krankenhausverweildauer, mehr Kosten und einer erhöhten Kurz- wie Langzeitmortalität einher. Die Ursachen für ein postoperatives Nierenversagen sind oft multifaktoriell, häufig bedingt durch das Aufeinandertreffen von patientenspezifischen und mit dem operativen Eingriff assoziierten Risikofaktoren. Die Inzidenz für postoperative Nierenfunktionsstörungen steigt mit der Zahl der Risikofaktoren dramatisch an. Bis zum heutigen Zeitpunkt existieren keine kausalen Therapiemöglichkeiten für eine eingetretene Nierenschädigung, sodass die Identifikation von Risikopatienten und die Vermeidung bzw. Reduktion noxischer Stimuli für die Niere die Primärziele darstellen. Die Übersichtsarbeit gibt einen Überblick über patienteninhärente und mit chirurgischen Eingriffen assoziierte Risikofaktoren für postoperative Nierenfunktionsstörungen. Darüber hinaus wird der aktuelle Wissensstand bezüglich der am weitesten verbreiteten Interventionsmöglichkeiten zur Vermeidung von Nierenschädigungen dargestellt.

Abstract

A substantial proportion of all acute in-hospital disturbances of renal function occur in the postoperative phase. Postoperative renal failure is accompanied by an extended stay in hospital, increased treatment costs and increased short-term and long-term mortality rates. The causes of postoperative renal failure are often multifactorial, whereby the concurrence of patient-specific risk factors as well as risk factors associated with the operative procedure often give rise to disturbances of renal function. The incidence of postoperative disturbances of renal function increases dramatically with the number of risk factors. At present there are no causal therapy options to treat renal damage when it occurs, so that identification of high-risk patients and avoidance or reduction of noxious stimuli for the kidneys, represent the primary goal for the physician. This review article gives an overview of patient-inherent and intervention-associated risk factors for postoperative disturbances of renal function. Furthermore, the current state of knowledge with respect to the most popular options for interventions to avoid renal damage will be described.

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Authors and Affiliations

  1. Abteilung für Anaesthesiologie und Intensivmedizin, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland

    J. Roggenbach

  2. Medizinische Klinik, Sektion für Nephrologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    C. Morath

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  1. J. Roggenbach
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  2. C. Morath
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Correspondence to J. Roggenbach.

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Roggenbach, J., Morath, C. Postoperatives Nierenversagen. Nephrologe 4, 118–127 (2009). https://doi.org/10.1007/s11560-008-0242-z

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