Risk factors of acute kidney injury in children after cardiac surgery

Abstract

Preoperative serum albumin level, age <12 months, preoperative pulmonary hypertension, and CPB duration were associated with risk for postoperative AKI in children who underwent congenital cardiac surgery.

The Year in Review: Anesthesia for Congenital Heart Disease 2019

“…21 A retrospective study of 505 children undergoing cardiac surgery with the primary objective of determining risk factors for AKI, and its association with serum albumin levels in particular. 22 After multivariate analysis, CPB time (odds ratio [OR] ¼ 1.006, 95% confidence interval [CI] ¼ 1.003-1.009; P ¼ .002), age <12 months (OR ¼ 1.911, 95% CI ¼ 1.166-3.132; P ¼ .007), and pulmonary hypertension (OR ¼ 1.853, 95% CI ¼ 1.182-2.907; P ¼ .01) were found to be independent risk factors for AKI. Lee and colleagues found that higher preoperative albumin was associated with reduced AKI risk (OR ¼ 0.506, 95% CI ¼ 0.325-0.788; P ¼ .003).…”

“…Lee and colleagues found that higher preoperative albumin was associated with reduced AKI risk (OR ¼ 0.506, 95% CI ¼ 0.325-0.788; P ¼ .003). 22 Furthermore, the more severe the hypoalbuminemia, the greater the risk of more severe AKI. Patients with AKI had increased pulmonary complication, re-sternotomy, ICU and hospital LOS, and days of mechanical ventilation.…”

“…The authors conclude that a higher preoperative albumin may be protective against postoperative AKI with a serum albumin of 4.5 g/dL decreasing the risk of AKI by 64%, and a serum albumin of >3.5 g/dL decreasing risk by 47%. 22 Hasson et al were interested in risk factors for recurrent AKI in children undergoing multiple cardiac surgeries. 23 Given the increasing number of children undergoing multiple cardiac surgeries, especially for single ventricle palliation, it is warranted for clinicians to understand the risk factors for adverse outcomes in these children.…”

Estudo da Lesão Renal Aguda em pacientes pediátricos no pós-operatório de cirurgia cardíaca

“…Ao comparar as cardiopatias cianogênicas com as não cianogênicas na análise univariada foi encontrado OR 2.6 de LRA, compatível ao estudo iraniano que demonstrou ser preditor independente da ocorrência de LRA, associação também relatada nos estudos de Taylor e Wilder (AMNI et al, 2017;TAYLOR et al, 2013;WILDER et al, 2017) (ZAPPITELLI et al, 2009;LEX et al, 2014;RICCI et al, 2013 PEDERSEN et al, 2007;LI et al, 2011;TAYLOR et al, 2013). (WILDER et al, 2017;LEE et al, 2018).…”

“…Essa relação pode ser devido a menor massa muscular e pior estado nutricional desses pacientes (LI et al, 2011;AMNI et al, 2017). Ricci et al (PARK et al, 2016;LEE et al, 2018;RICCI et al, 2013 (BLINDER et al, 2012;PEDERSEN et al, 2007).…”