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Continuous hemodiafiltration in children after cardiac surgery

Kenichi Watanabe1, Yasuyuki Suzuki, Takeshi Goto

  • 1Department of Thoracic and Cardiovascular Surgery, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan.

Artificial Organs
|November 25, 2010
PubMed

Insights

Continuous hemodiafiltration (CHDF) effectively treated acute renal failure in pediatric patients after congenital cardiac surgery. Most patients recovered normal renal function, demonstrating CHDF as a viable treatment option for this critical complication.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Surgery
  • Critical Care Medicine

Background:

  • Acute renal failure (ARF) is a significant complication following congenital cardiac surgery, leading to increased morbidity and mortality in pediatric patients.
  • Continuous hemodiafiltration (CHDF) is an established treatment modality for pediatric renal replacement therapy.

Purpose of the Study:

  • To retrospectively evaluate the efficacy and outcomes of CHDF in managing ARF in pediatric patients who underwent congenital cardiac surgery.
  • To assess the impact of CHDF on renal function recovery and identify potential complications associated with the treatment.

Main Methods:

  • Retrospective analysis of seven pediatric patients (23 days to 9 years) who received CHDF for ARF post-congenital cardiac surgery between April 2002 and January 2009.
  • Data collected included patient demographics, duration of CHDF, ultrafiltration rates, and pre- and post-treatment serum creatinine and urea levels.

Main Results:

  • Renal function recovered to normal in five out of seven (71%) patients.
  • Significant reductions in serum creatinine (2.3 to 0.5 mg/dL) and urea (43.7 to 13.5 mg/dL) were observed post-CHDF (P < 0.05).
  • Common complications included thrombocytopenia in all patients, requiring platelet concentrate infusion, and transient hypotension in one patient.

Conclusions:

  • CHDF is an effective strategy for treating renal dysfunction in pediatric patients following congenital cardiac surgery.
  • Despite complications like thrombocytopenia, CHDF facilitates renal function recovery and offers a beneficial treatment option.

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