Acute renal dysfunction after cardiac surgery: still a big problem!

This review will address the issue that renal dysfunction post cardiac surgery, whether pre-existent or developing de novo, is a major contributor to morbidity as well as short- and long-term survival. The ability to recognise diminished renal reserve through estimating glomerular filtration rate, makes clinicians more vigilant to protecting renal function through better haemodynamic post-operative management and avoidance of nephrotoxins. Further the application of the recent consensus classification of acute renal dysfunction allows early recognition of renal impairment and earlier intervention with renal replacement therapy. This early renal replacement therapy has been shown to lead to better outcome.