Perioperative risk assessment, prevention, and treatment of acute kidney injury.

In the perioperative period, physicians strive to provide optimal care for their patients by first performing a thorough evaluation of all organ systems. This is most important for elective and nonelective highrisk procedures and for procedures performed on critically ill or medically complex patients. The perioperative period is unique as it is a distinct event in a patient’s health where certain hemodynamic derangements and insults are somewhat predictable based on the preoperative state of the patient and the type of surgery required. It is a time when preventive therapy can be instituted for certain patient populations if their risk is adequately determined. The field of perioperative medicine is advancing in many areas. For instance, many studies have focused on the risk and prevention of perioperative cardiac events. The risk and prevention of acute kidney injury (AKI) is less well understood and shall be the topic of this chapter.