In a multinational randomized clinical trial of high-risk adults undergoing major surgery, implementation of a Kidney Disease: Improving Global Outcomes (KDIGO)-based preventive care bundle significantly reduced the incidence of moderate to severe acute kidney injury within 72 hours compared with usual care. The intervention—guided by urinary biomarkers and including hemodynamic optimization, avoidance of nephrotoxins, and glycemic control—achieved a number needed to treat of 12 without increasing adverse events.

Source: The Lancet Study, Commentary