الفهرس 
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Abstract
Cardiac surgery associated acute kidney injury (CSA‑AKI) is a serious complication after cardiac surgery. The presence of CSA-AKI may increase the odds of operative morbidities & mortality and the length of the hospital stay.
Acute Kidney Injury defined as an increase in S.Cr within 48h of at least 0.3 mg/dl or 150–200% (1.5- to 2-fold) from the baseline. Urine output was not used in calculating AKI due to diuretic use.
The study included 107 patient above 18 years both sex admitted to Shebin Elkom Teaching Hospital and Menoufia University Hospital during the period from September 2018 to March 2019 and subjected to cardiac surgery.
Various mechanisms pre, intra and post-operative factors responsible for the occurrence of AKI in cardiac surgery such as inflammatory reactions, ischemia-reperfusion injury, hemolysis, exposure to nephrotoxic agents and oxidative stress.
The incidence of acute kidney injury post on-pump cardiac surgery is 42.06% within first 48h.
The most common comorbidities were hypertension and diabetes mellitus.
Age, sex, smoking, HTN, DM are not predictor of AKI.
The most common surgical procedure is Valve operation performed in 53 case (49.5%), followed by CABG in 45 case (42.1%). Due to younger age of patient valve more common in this study.
There is a significant increase in WBC count after on-pump cardiac surgery.
This study there is highly significant difference between Urea and Creatinine Pre &48h-Post.
Administration of contrast is a predictors of AKI and dose of contrast has significant value. It is risk of AKI about 2 fold.
Calcium, Phosphorus, LL Edema, chest, Lipid profile, Hb and HbA1C are not predictors of AKI.
Anti-platelets, NSAIDs, Statins, Metformin, ACEI, Diuretics, Digitalis, B-Blockers, Antibiotics are not predictor of AKI. Nitrates is the only significant predictor value. It protects the occurrence of AKI. It is veno and arterio-dilator so increasing GFR.
Avoidance of AKI by preventive measures remains the mainstay of management in high‑risk patients. Contrast induced AKI is an exception in that it is preventable and manageable by hydration, N‑acetyl cysteine, and bicarbonate.
Identification and categorization of high risk patients by risk prediction models allow optimal decision‑making for early intervention and better management.