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Risk factors for acute renal failure requiring dialysis after surgery for congenital heart disease in children

K R Pedersen1, J V Povlsen, S Christensen

  • 1Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, Denmark.

Acta Anaesthesiologica Scandinavica
|October 20, 2007
PubMed

Insights

Young age, high Risk Adjusted Classification of Congenital Heart Surgery (RACHS-1) score, and cardiopulmonary bypass (CPB) are key risk factors for acute renal failure (ARF) in children undergoing heart surgery. ARF incidence decreased over time, but it significantly increases ICU stay and mortality.

Area of Science:

  • Pediatric Cardiology
  • Nephrology
  • Critical Care Medicine

Background:

  • Limited data exists on acute renal failure (ARF) risk factors in children with congenital heart disease undergoing cardiac surgery.
  • This study examines ARF risk factors, incidence changes, mortality, and ICU stay from 1993-2002.

Purpose of the Study:

  • Identify independent risk factors for ARF post-cardiac surgery in pediatric congenital heart disease patients.
  • Analyze trends in ARF incidence, in-hospital mortality, and ICU length of stay over a decade.

Main Methods:

  • A cohort study of 1128 children who underwent cardiac surgery for congenital heart disease between 1993 and 2002.
  • Data were extracted from a prospectively collected ICU database to identify potential risk factors for ARF.

Main Results:

  • 11.5% of children (130) developed ARF. Independent risk factors identified: young age, high Risk Adjusted Classification of Congenital Heart Surgery (RACHS-1) score, and cardiopulmonary bypass (CPB) duration.
  • The incidence of ARF decreased during the study period. ARF patients had significantly longer ICU stays and higher in-hospital mortality (20% vs. 5%).

Conclusions:

  • Young age, high RACHS-1 score, and CPB are significant independent risk factors for ARF in pediatric cardiac surgery for congenital heart disease.
  • The risk of ARF has decreased, but ARF remains associated with increased ICU utilization and mortality in this vulnerable population.
Abstract

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