Biomarker-guided Implementation of the AKI Bundle

Biomarker-guided Implementation of the Cardiovascular (CV) Surgery AKI Bundle to Reduce the Occurrence of AKI After Cardiac Surgery- Prevention of AKI

There is no specific therapy for acute kidney injury. It is presumed that supportive measures improve the care and outcome of patients with acute kidney injury.

The investigators hypothesize that the implementation of a bundle of supportive measures adapted to patients undergoing cardiovascular surgery reduces the occurence of AKI.

A Randomized prospective multicenter trial is needed to investigate whether the implementation of the bundle of measures is effective to prevent AKI in high risk patients undergoing cardiac surgery. In this feasibility trial the investigators will analyze the compliance rate to the trial protocol in a multicenter, multinational cohort in preparation for a large randomized controlled trial.

Inclusion Criteria:

• Adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB)
• Urinary [TIMP-2] * [IGFBP7] >= 0.3 4h after CPB
• Written informed consent

Exclusion Criteria:

• Preexisting AKI (stage 1 and higher)
• Patients with cardiac assist devices (ECMO, LVAD, RVAD, IABP)
• Pregnancy, breastfeeding
• Known (Glomerulo-)-Nephritis, intersstitial nephritis or vasculitis
• CKD with eGFR < 20 mL/min
• Dialyses dependent CKD
• Prior kidney transplant within the last 12 months