Suparna Dutta, MD, MPH and Hiro Hayashi, MD

Based on the original module, Perioperative Acute Kidney Injury: Diagnosis and Management, by Adam Schaffer, MD, and Sylvia McKean, MD

If you are a Program Director and would like to grant access to your trainees, please reach out to education@hospitalmedicine.org for an academic access code.

Summary

Acute kidney injury (AKI) is an important complication following cardiac and noncardiac surgery. Up to 18% of hospitalized patients develop AKI, and those who are critically ill have an even higher risk. Comparatively, the incidence of AKI in the perioperative period is 18-47%.¹ Patients with even modest increases in their serum creatinine have increases in their mortality, morbidity, length of stay, and hospital costs. Perioperative AKI is associated with an increased risk of sepsis, anemia, coagulopathy, and mechanical ventilation. Notably, mortality is higher in patients with perioperative AKI even after complete renal recovery.¹ Perioperative AKI correlates with type of surgical procedure, patient characteristics, volume status, hemodynamics, and exposure to nephrotoxins. Presurgical risk stratification and early risk mitigation is extremely important to avoid injury and need for renal replacement therapy (RRT). The following module defines perioperative AKI, identifies specific risk factors and tools for risk stratification, provides an overview of the workup of perioperative AKI, and evaluates various renal protective strategies that can be implemented during this high-risk period.

Goal

To provide hospitalists with current management strategies regarding the prevention, identification, and treatment of patients with perioperative AKI.

Target Audience

This activity is designed for hospitalists. No prerequisites required.

Learning Objectives

After completing the module, the participant will demonstrate the ability to: 

1. Describe the definitions and epidemiology of perioperative AKI
2. Detail the risk factors for development of perioperative AKI
3. Utilize an evidence-based approach to diagnose the etiology of perioperative AKI
4. Analyze the current evidence for medical AKI risk reduction therapies

Accreditation Statement

The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Statement Designation

The Society of Hospital Medicine designates this activity for a maximum of 2.00 AMA PRA Category 1 Credits^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Release Date: September 1, 2021                      Expiration Date: September 1, 2024

Estimated time to complete: 2 hours

Conflict of Interest Disclosure Policy

In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM mitigates all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

Instructions

The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of several sections: a pre-test, a study program, a post-test, and a CME evaluation. All sections must be completed to receive CME credit.