Comment on; post-transcatheter aortic valve replacement acute kidney injury; prevention rather than cure

Implication for health policy/practice/research/medical education: There is newly accumulating evidence in the surgery-acute kidney injury (AKI) literature that intraoperative hypotension (IOH) is a formidable and yet preventable causative factor in precipitating postoperative AKI. Postoperative AKI portends both increased short- and long-term morbidity and mortality, increased length of stay and higher healthcare costs. IOH is preventable. We present a case of AKI that led to the syndrome of rapid onset end stage renal disease (SORO-ESRD) in a 73-year-old diabetic hypertensive chronic kidney disease (CKD) male patient in 2012 following minimally invasive surgical aortic valve replacement. We call for more attention to be paid to IOH and to avoid too low blood pressures in the operating room. We posit that systolic blood pressure targets ≥ 90 mm Hg and/or MABP targets ≥ 60 mm Hg potentially would improve postoperative renal outcomes.