Acute kidney injury and renin preoperatively in lung transplant and non-cardiac surgery

The student will undertake one of the following projects. The choice of project will depend on student preference and resource availability (time and funding). 1) Acute kidney injury is very common after lung transplantation. Studies in cardiac surgery have suggested improved GFR and renal outcomes occur in patients given an infusion of amino acids for 72 hours. We aim to carry out a study to determine whether infused amino acids improve renal outcomes in lung transplant patients. a. Population: lung transplantation patients b. Intervention: 72 hours infusion of amino acids perioperatively c. Comparison: Placebo infusion d. Outcome: Delta creatinine 2) Renin:aldosterone ratio has been found to be predictive of vasoplegia and other complications in cardiac surgery. To date, no studies have been carried out in non-cardiac surgery patients. We aim to carry out an observational study to determine if renin and aldosterone levels are predictive of complications in a high risk, non-cardiac surgery population. 3) Acute kidney injury is very common after lung transplantation. The Alfred hospital is one of the largest centres in the world carrying out lung transplantation. Vasopressors are commonly used in lung transplant including noradrenaline and vasopressin. In this retrospective study we will use the transplant database and Cerner to identify whether vasopressors are predictive of kidney injury, and if a specific threshold dose of vasopressor exists where AKI becomes more likely.