AUTHOR=Permeisari Dias 

TITLE=Future insights of pharmacological prevention for AKI post cardiopulmonary bypass surgery (based on PK/PD approach)

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.975641

DOI=10.3389/fphar.2022.975641

ISSN=1663-9812

ABSTRACT=The incidence of acute kidney injury (AKI) post-cardiopulmonary bypass (CPB) can cause an increase in the rate of renal replacement therapy (RRT) and mortality rate. Compared to brain and liver damage post-CPB, AKI has the highest incidence of 42%. Based on this phenomenon, various efforts have been made to reduce the incidence of AKI post-CPB, both pharmacologically and non-pharmacologically interventions. The purpose of this review is to emphasize several renal protector agents which under optimal conditions can provide significant benefits in reducing the incidence of AKI post-CPB. This article was obtained by conducting a study on several literatures, including the original article, RCT study, systematic review and meta-analysis, and other review articles. There are four renal protector agents that are the focus of this article, those are fenoldopam which effectively works to prevent the incidence of AKI post-CPB, while furosemide has shown satisfactory results in patients with decreased renal function when administered in the Renal Guard (RG) system, mannitol and nitric oxide, both of these can also effectively reduce the incidence of AKI post-CPB by controlling its blood concentration and timing of administration. The benefits of these agents can be obtained by developing devices that can control drug levels in the blood and create optimal conditions for drugs during use of the CPB machine.