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[Drug induced acute renal failure after heart surgery (author's transl)]
Insights
Acute renal failure in children post-cardiac surgery was linked to intravenous Aescin. Removing Aescin from post-operative therapy resolved this issue, improving patient outcomes.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Surgery
- Clinical Pharmacology
Context:
- Increased incidence of acute renal failure (ARF) observed in pediatric patients following cardiac surgery.
- No correlation found with traditional risk factors like pre-existing conditions or intraoperative events.
- ARF primarily affected children aged 2-10 years, manifesting 3-4 days post-surgery.
Purpose:
- To investigate the potential causes of a surge in post-cardiac surgery acute renal failure in pediatric patients.
- To identify specific etiological factors contributing to this adverse event.
- To evaluate the impact of therapeutic interventions on ARF incidence.
Summary:
- A retrospective analysis identified a correlation between intravenous Aescin administration and the development of ARF in pediatric cardiac surgery patients.
- Peritoneal dialysis was required in 39% of affected patients, with an overall mortality rate of 10.7%.
- Discontinuation of Aescin in post-operative care led to a significant reduction in ARF cases.
Impact:
- Highlights a potential iatrogenic cause of acute renal failure in a vulnerable pediatric population.
- Suggests a critical need for re-evaluation of Aescin use in post-cardiac surgery protocols.
- Demonstrates the significant impact of drug withdrawal on improving patient outcomes and reducing healthcare burden.
Abstract:
The incidence of acute renal failure following cardiac surgery was markedly increased during the last years in our medical center. There was no correlation to known etiologic factors such as preexisting disease, hemolysis, low perfusion rates, post-operative low output syndrome etc. Post-operative renal failure was mainly seen in children between 2 and 10 years and was noted after 3-4 days of normal renal function. Peritoneal dialysis was carried out in 39% of out patients and the overall mortality was 10.7%. Careful analysis of our cases exhibited a correlation of the post operative acute renal failure to the intravenous application of Aescin. After abandoning this drug from our post-operative therapy we did not observe a similar case since almost one year.