Risk Factors for Acute Kidney Injury after Congenital Cardiac Surgery in Infants and Children: A Retrospective Observational Study

• DOI: 10.1371/journal.pone.0166328
• Publication Date: 2016-11-10T13:56:56Z
• Authors: Sun-Kyung Park; Min Hur; Eunhee Kim; Won Ho Kim; Jung Bo Park; Youngwon Kim; Ji-Hyuk Yang; Tae-Gook Jun; Chung Su Kim
• Keywords: Adult; Male; Adolescent; Science; Risk Assessment; Young Adult; 03 medical and health sciences; Postoperative Complications; 0302 clinical medicine; Risk Factors; Humans; Cardiac Surgical Procedures; Child; Retrospective Studies; Cardiopulmonary Bypass; Incidence; Q; R; Infant, Newborn; Infant; Acute Kidney Injury; 3. Good health; Child, Preschool; Medicine; Female; Research Article

Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high morbidity and mortality. Modifiable risk factors for postoperative AKI including perioperative anesthesia-related parameters were assessed. The authors conducted a single-center, retrospective cohort study of 220 patients (aged 10 days to 19 years) who underwent congenital between January December 2012. incidence within 7 postoperatively was determined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Ninety-two (41.8%) developed 18 (8.2%) required renal replacement therapy first week. Among AKI, 57 (25.9%) KDIGO stage 1, 27 (12.3%) 2, eight (3.6%) 3. RACHS-1 (Risk-Adjusted classification Congenital Heart Surgery) category, transfusion fluid administration as well overload compared without AKI. Multivariable logistic regression analyses longer hospital stay or ICU stay, frequent sternal wound infections. Younger age (<12 months) [odds ratio (OR), 4.01; 95% confidence interval (CI), 1.77-9.06], cardiopulmonary bypass (CPB) time (OR, 2.45; CI, 1.24-4.84), low preoperative hemoglobin 2.40; 1.07-5.40) independent Fluid not significant predictor When variable concentration increase (>3 g/dl) from level on POD1 entered into multivariable analysis, it independently 6.51; 2.23-19.03 no increase). This association adjustment patient demographics, medication history category (hemoglobin >3g/dl vs. increase: adjusted OR, 6.94; 2.33-20.69), regardless different groups cyanotic non-cyanotic heart disease. Prospective trials are evaluate whether correction anemia prevention hemoconcentration may ameliorate in surgery.