Risk of acute kidney injury in the management of coronary artery disease: Should we favor PCI or CABG?

Acute kidney injury (AKI), an abrupt impairment of renal function following diagnostics or therapeutic measures, is an important cause of morbidity and mortality in the management of coronary artery disease. Distinguishable based on underlying etiology and pathogenesis, post-surgery and contrast induced AKI are the two most frequent forms of renal impairment in the clinical setting. Risk stratification remains a valuable tool in optimizing clinical decisions and treatment strategies, especially when current preventive and treatment measures lack high efficacy. Late progress in the understanding of renal impairment etiopathogeny needs to be supported by clinical trials in order to provide novel therapeutic options that will lower the mortality and morbidity associated with AKI. Keywords: acute kidney injury; coronary artery disease; coronary artery bypass; percutaneous coronary intervention; risk. Received: April 1, 2014; Accepted: June 12, 2014; Published: January 19, 2015 Corresponding Author: Professor Arie Pieter Kappetein, MD PhD, Department of Cardiothoracic Surgery, Erasmus University Medical Center, 's-Gravendijkwal 230, 3000 CA Rotterdam, The Netherlands. E-mail: a.kappetein@erasmusmc.nl .