Related Experiment Video
Updated: Oct 10, 2026
Technical Refinement of a Bilateral Renal Ischemia-Reperfusion Mouse Model for Acute Kidney Injury Research
Published on: November 3, 2023
Outcome of acute renal failure associated with cardiac surgery in infants
J E Romao1, M G Fuzissima, A F Vidonho
1Real e Benemérita Beneficência Portuguesa de São Paulo, São Paulo, SP, Brazil.
Insights
Acute renal failure (ARF) significantly increases mortality in infants after cardiac surgery, especially in those with oliguric ARF. Peritoneal dialysis is primarily for hypervolemia, not uremia.
Area of Science:
- Pediatric Nephrology
- Pediatric Cardiology
- Critical Care Medicine
Background:
- Acute renal failure (ARF) is a critical complication in infants undergoing cardiac surgery.
- Understanding the impact of ARF on this vulnerable population is essential for improving outcomes.
Purpose of the Study:
- To analyze the impact of acute renal failure (ARF) on the clinical course and outcomes of infants undergoing cardiac surgery.
- To identify risk factors and predictors of mortality in this patient group.
Main Methods:
- Retrospective analysis of 15 infants who developed ARF post-cardiac surgery.
- Evaluation of demographic, clinical, surgical data, and patient evolution.
- Assessment of dialysis indications and outcomes.
Main Results:
- The overall mortality rate was 60%, with significantly higher mortality in oliguric ARF (73%) versus non-oliguric ARF (25%).
- Cardiac dysfunction and sepsis were the primary causes of ARF and mortality.
- Peritoneal dialysis was mainly indicated for hypervolemia.
Conclusions:
- ARF poses a high mortality risk for infants undergoing cardiac surgery.
- Oliguria is a significant predictor of increased mortality.
- Management strategies should focus on addressing hypervolemia and underlying cardiac conditions.
Objective:
To analyze the impact of acute renal failure (ARF) on the evolution of infants undergoing cardiac surgery.
Methods:
We assessed 15 infants undergoing cardiac surgery who developed (ARF). Their demographic, clinical and surgical data, and evolution were analyzed.
Results:
Their mean age was 4.4+/-4.0 months (8 days to 24 months). Twelve infants were males, and 4 patients already had ARF at surgery. The primary cause of ARF was immediate acute cardiac dysfunction in 10 infants, cardiac dysfunction associated with sepsis in 2 infants, and isolated sepsis in 3 infants. All children depended on mechanical ventilation during their postoperative period, 14 infants used vasoactive drugs, and 11 had an infectious process associated with ARF. Thirteen infants required dialytic treatment. Eleven infants developed oluguric ARF, and all had to undergo peritoneal dialysis; of the 4 patients with non-oliguric, 2 required dialysis, the main indication being hypervolemia. Of these 13 dialyzed infants, 4 died in the first 24 hours because of the severity of the underlying cardiac disease (mean urea level of 49+/-20 mg/dl). The mortality rate for the entire group was 60%, and it was higher among the patients with oliguria ARF (73% vs 25%, p<0. 001). The cause of death was acute cardiac dysfunction in 6 infants (early type-1 ARF) and sepsis in the 3 remaining infants (late type-2 ARF).
Conclusion:
The mortality rate of ARF associated with cardiac surgery in infants was hight, being higher among children with oliguria; peritoneal dialysis was indicated due to clinically uncontrolled hypervolemia and not to the uremic hypercatabolic state.
Related Concept Videos
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:22Acute Kidney Injury I: Introduction
01:20Acute Kidney Injury V: Interprofessional Care
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:29Acute Kidney Injury III: Clinical Manifestations
01:22Acute Kidney Injury VI: Nursing Management