Acute kidney injury according to pediatric RIFLE criteria is associated with negative outcomes after heart surgery in children

Halal, Michel Georges dos Santos El; Carvalho, Paulo Roberto Antonacci

doi:10.1007/s00467-013-2495-7

Cited by 30 publications

(16 citation statements)

References 31 publications

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“…A decrease in estimated creatinine clearance at least 25%, 50% or 75% corresponds to R, I or F respectively in pRIFLE classification. Persistent renal failure for more than 4 weeks or 3 months corresponds to L or E, respectively . According to the pRIFLE criteria, patient reached a pRIFLE maximum of Risk and Injury was defined as CIN in the 24 h after exposure to contrast media in the absence of other cause of renal failure.…”

Section: Methodsmentioning

confidence: 99%

The effects of dexmedetomidine on early stage renal functions in pediatric patients undergoing cardiac angiography using non‐ionic contrast media: a double‐blind, randomized clinical trial

Bayram

Ülgey

Baykan

et al. 2014

Pediatric Anesthesia

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Section: Methodsmentioning

confidence: 99%

The effects of dexmedetomidine on early stage renal functions in pediatric patients undergoing cardiac angiography using non‐ionic contrast media: a double‐blind, randomized clinical trial

Bayram

Ülgey

Baykan

et al. 2014

Pediatric Anesthesia

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“…Recent reports of AKI using current definitions in large pediatric populations undergoing congenital heart disease surgery have revealed an incidence of 40–50% [1,3,12–14], with an even higher incidence of 64% among neonates [15]. More importantly, pediatric CS-AKI has been consistently associated with a number of complications including increased morbidity and mortality in this population.…”

Section: Incidence and Etiology Of Cardiac Surgery-associated Acutmentioning

confidence: 99%

Early detection of acute kidney injury after pediatric cardiac surgery

Jefferies

Devarajan

2016

Progress in Pediatric Cardiology

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Acute kidney injury (AKI) is increasingly recognized as a common problem in children undergoing cardiac surgery, with well documented increases in morbidity and mortality in both the short and the long term. Traditional approaches to the identification of AKI such as changes in serum creatinine have revealed a large incidence in this population with significant negative impact on clinical outcomes. However, the traditional diagnostic approaches to AKI diagnosis have inherent limitations that may lead to under-diagnosis of this pathologic process. There is a dearth of randomized controlled trials for the prevention and treatment of AKI associated with cardiac surgery, at least in part due to the paucity of early predictive biomarkers. Novel non-invasive biomarkers have ushered in a new era that allows for earlier detection of AKI. With these new diagnostic tools, a more consistent approach can be employed across centers that may facilitate a more accurate representation of the actual prevalence of AKI and more importantly, clinical investigation that may minimize the occurrence of AKI following pediatric cardiac surgery. A thoughtful management approach is necessary to mitigate the effects of AKI after cardiac surgery, which is best accomplished in close collaboration with pediatric nephrologists. Long-term surveillance for improvement in kidney function and potential development of chronic kidney disease should also be a part of the comprehensive management strategy.

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“…Furthermore, children with congenital heart disease are exposed to several factors that lead to AKI, including cardiac surgery (often multiple for step-wise repair of complex anatomic derangements) and nephrotoxin use. Recent reports of AKI using current definitions in large pediatric populations undergoing congenital heart disease surgery have revealed an incidence of 40–50%, 33–38 with an even higher incidence of 64% among neonates. 39 Evidence for, and mechanisms underlying, the transition from AKI to CKD are discussed in sections 6 and 7 of this review.…”

Section: Incidence and Etiology Of Ckdmentioning

confidence: 99%

Progression of chronic kidney disease after acute kidney injury

Devarajan

Jefferies

2016

Progress in Pediatric Cardiology

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The incidence of chronic kidney disease (CKD) in children and adults is increasing. Cardiologists have become indispensable members of the care provider team for children with CKD. This is partly due to the high incidence of CKD in children and adults with congenital heart disease, with current estimates of 30–50%. In addition, the high incidence of acute kidney injury (AKI) due to cardiac dysfunction or following pediatric cardiac surgery that may progress to CKD is also well documented. It is now apparent that AKI and CKD are uniquely intertwined as interconnected syndromes. Furthermore, the well-known long-term cardiovascular morbidity and mortality associated with CKD require the joint attention of both nephrologists and cardiologists. Children with both congenital heart disease and CKD are increasingly surviving to adulthood, with synergistically negative medical, financial, and quality of life impact. An improved understanding of the epidemiology, mechanisms, early diagnosis, and preventive measures is of importance to cardiologists, nephrologists, scientists, economists, and policy makers alike. Herein, we report the current definitions, epidemiology, and complications of CKD in children, with an emphasis on children with congenital heart disease. We then focus on the clinical and experimental evidence for the progression of CKD after episodes of AKI commonly encountered in children with heart disease, and explore the role of novel biomarkers for the prediction of CKD progression.

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Acute kidney injury according to pediatric RIFLE criteria is associated with negative outcomes after heart surgery in children

Abstract: The occurrence of AKI according to pRIFLE criteria is associated to adverse outcomes in children after heart surgery.

Cited by 30 publications

References 31 publications

The effects of dexmedetomidine on early stage renal functions in pediatric patients undergoing cardiac angiography using non‐ionic contrast media: a double‐blind, randomized clinical trial

The effects of dexmedetomidine on early stage renal functions in pediatric patients undergoing cardiac angiography using non‐ionic contrast media: a double‐blind, randomized clinical trial

Early detection of acute kidney injury after pediatric cardiac surgery

Progression of chronic kidney disease after acute kidney injury

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