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Prevention and Management of AKI in ACS Patients Undergoing Invasive Treatments

  • Management of Acute Coronary Syndromes (H Jneid, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Management of patients presenting with acute coronary syndrome (ACS) includes invasive procedures that may increase the risk of acute kidney injury (AKI). AKI adversely affects the outcomes of such procedures and complicates the management of ACS. We have summarized several strategies for the prevention and management of AKI in this critical patient group including in the pre-procedural, intraprocedural, and post-procedural settings.

Recent Findings

Definitive prevention and management strategies for AKI in patients presenting with ACS requiring invasive management can be confounded by the variation in data outcomes.

Summary

Pre-procedural hydration with normal saline when accounting for time to catheterization, radial artery access, contrast stewardship, and close monitoring of renal function after catheterization should be implemented.

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Abbreviations

CT:

Computerized tomographic

MRI:

Magnetic resonance imaging

CIN:

Contrast induced nephropathy

CA-AKI:

Contrast associated acute kidney injury

AKI:

Acute kidney injury

ACS:

Acute coronary syndrome

RIFLE:

Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease

AKIN:

Acute Kidney Injury Network

GFR:

Glomerular filtration rate

PCI:

Percutaneous coronary intervention

CAD:

Coronary artery disease

VA-ECMO:

Veno-arterial extracorporeal membrane oxygenation

pLVAD:

Percutaneous left ventricular assist device

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Cardiology, Medical Branch, University of Texas, 301 University Blvd, Galveston, TX, 77550, USA

    Ravi A. Thakker, Aiham Albaeni, Haider Alwash & Syed Gilani

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  1. Ravi A. Thakker
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  2. Aiham Albaeni
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  3. Haider Alwash
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  4. Syed Gilani
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All authors contributed to the conception, drafting, and review of this manuscript and meet ICJME criteria for authorship.

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Correspondence to Syed Gilani.

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This article is part of the Topical Collection on Management of Acute Coronary Syndromes

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Thakker, R.A., Albaeni, A., Alwash, H. et al. Prevention and Management of AKI in ACS Patients Undergoing Invasive Treatments. Curr Cardiol Rep 24, 1299–1307 (2022). https://doi.org/10.1007/s11886-022-01742-0

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