الفهرس 
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Abstract
Due to the significant expansion of the cardiac surgery specialty, more patients with multiple co-morbidities and advanced age can now be treated. Despite a wealth of experienced cardiac procedures, older patients remain at increased risk of both morbidity and mortality.
One serious illness that occurs more frequently in the intensive care unit is AKI. Within this setting, among the leading factors contributing to acute renal failure aside from sepsis, is CSA-AKI. Also patients who developed AKI after cardiopulmonary bypass (CPB) also had higher rates of infection complications, longer hospital stays, and mortality than non-AKI patients.
Combining RIFLE and AKIN criteria, the Kidney Disease Improving Global Outcomes (KDIGO) work group has created a new, unified definition and classification of AKI for use in practice, research, and public health. The most widely used definitions of AKI, though many, diverse, and complex, are based on the amount of urine output (UO) and/or serum creatinine (sCr).
The multifaceted pathophysiology of CSA-AKI includes both endogenous and exogenous toxins, metabolic dysfunction, ischaemia and reperfusion injury, neurohormonal activation, inflammation, and oxidative stresses. Following heart surgery, it is distinguished by a severe decline in renal function, as seen by a decrease in glomerular filtration rate (GFR).
Notably, serum creatinine (sCr), creatinine clearance (CrCl), and urine output (UOP) values can be affected by several renal and non-renal factors that are unrelated to kidney injury or function. As a result, it may be challenging to identify this deterioration in the first 24 to 48 hours after surgery.