Thakar Score for AKI after Cardiac Surgery
Predicts risk of acute kidney injury (AKI) requiring dialysis after cardiac surgery. Helps identify high-risk patients for preventive strategies.
Score interpretation
→ Thakar Low Risk (0–2): <1% risk of post-cardiac surgery dialysis. Standard perioperative renal protection: maintain perfusion pressure, avoid nephrotoxins, ensure hydration.
→ Thakar Moderate Risk (3–5): 1–5% risk of dialysis. Nephrology input pre-op; careful fluid management; consider N-acetylcysteine; avoid contrast agents; early renal monitoring post-op.
→ Thakar High Risk (6–8): 5–20% risk of dialysis. Pre-op nephrology review; discuss risk with patient; CICU post-op; strict renal monitoring; early haemofiltration if AKI develops.
→ Thakar Very High Risk (≥9): >20% dialysis risk. Consider whether surgery risk is acceptable; pre-op renal optimisation; dialysis catheter placement before surgery; CICU with renal team co-management.
Interpretation bands for the Thakar AKI Score. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Protamine Sulphate (Heparin Reversal) · Heparin Reversal / Cardiac Surgery
- Mannitol (Osmotic Diuretic — Renal/Neurological) · Acute Oliguric Renal Failure / Raised ICP
- Enoxaparin (VTE Prophylaxis — Post-Surgery) · Low Molecular Weight Heparin (LMWH) — VTE Prophylaxis
- Rivaroxaban (Perioperative VTE Prophylaxis) · Direct Oral Anticoagulant — VTE Prophylaxis Post-Surgery
- Aprotinin · Antifibrinolytic — Cardiac Surgery
- Protamine Sulphate · Heparin Antidote — Vascular / Cardiac Surgery
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.