Predictors of acute kidney injury post-cardiopulmonary bypass in children

Abstract

AKI is common and occurred in 11% of our patients following CPB; however, AKI requiring renal replacement therapy is uncommon.

Acute kidney injury as a predictor of poor outcome post cardiopulmonary bypass in children

“…9,10 Similarly early recovery and less likelihood of progression to CKD has also been reported in earlier studies. [9][10][11]17,21 We found prolonged CPB time to be associated with higher odds of developing AKI which was consistent with previous studies. [9][10][11]21,22 The possible reason of longer CPB time associated with AKI is multifactorial and probably due to the physiological alternation occurring during CPB.…”

“…Low cardiac output and sepsis has also been associated with AKI in previous reports. 17,21 The current study shows a significant increase in mortality in patients with stage 2 and 3 AKI compared to those without. Similarly significantly higher requirement of prolonged ventilation and length of ICU stay was found in children with stage 2 and 3 AKI compared to those without.…”

“…Younger age has been associated with higher risk of AKI in previous reports; no significant difference could be found in the study. 10,21 AKI was also found to be more common in cyanotic patients, patient requiring unplanned re-exploration, patient having LV dysfunction and post-operative sepsis although no significant association could be established. Low cardiac output and sepsis has also been associated with AKI in previous reports.…”

Neutrophil gelatinase-associated lipocalin as a biomarker for acute kidney injury in children after cardiac surgery

“…2,[5][6][7]18,19,20,22,23 Sethi et al reported that duration of CPB >90 minutes could cause AKI in adults. 24 Similarly, Zheng et al reported that AKI was significantly more common in patients with duration of CPB >90 minutes. 20 Although the mechanism is unknown, the release of proinflammatory mediators, coagulation products, oxidation products, and the adhesion of blood cells to the vascular endothelium reportedly increases with prolonged CPb time.…”

Anesthesia for Cardiac Surgery in Neonates

“…In recent years, there has been growing interest to elucidate the risk factors for AKI in infants undergoing cardiothoracic procedures with CPB. Five factors have been shown to predict AKI including younger age, weight <10 kg, myocardial dysfunction, sepsis, and duration of CPB >90 min [ 286 ]. Another study reported multiple perioperative risk factors for acute kidney risk or injury, failure, and mortality in children undergoing CPB [ 290 ].…”