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Acute kidney injury is associated with higher morbidity and resource utilization in pediatric patients undergoing

Roland Tóth1, Tamás Breuer, Zsuzsanna Cserép

  • 1School of PhD Studies, Department of Cardiovascular Surgery, Semmelweis University, Budapest, Hungary.

The Annals of Thoracic Surgery
|January 10, 2012
PubMed

Insights

Pediatric cardiac surgery patients with acute kidney injury (AKI) experienced more complications, including longer hospital stays and increased need for dialysis. However, AKI was not significantly associated with increased mortality in this study.

Area of Science:

  • Pediatric Nephrology
  • Pediatric Cardiology
  • Critical Care Medicine

Background:

  • The Risk, Injury, Failure, Loss, and End-stage Renal Disease (RIFLE) classification system standardizes acute kidney injury (AKI) definition in adults.
  • The study investigates the association between AKI and patient outcomes following pediatric cardiac surgery.

Purpose of the Study:

  • To determine if acute kidney injury (AKI) is associated with increased mortality and morbidity in pediatric patients undergoing cardiac surgery.
  • To analyze the impact of AKI on postoperative complications and outcomes.

Main Methods:

  • Acute kidney injury (AKI) was defined using pediatric-modified RIFLE (pRIFLE) criteria based on creatinine clearance.
  • Propensity score analysis matched 325 AKI patients with 325 non-AKI patients from a cohort of 1,510 pediatric cardiac surgery cases (2004-2008).
  • Perioperative variables were matched to analyze the association between AKI and outcomes.

Main Results:

  • 31.9% of patients developed AKI, with 18.7% meeting the 'failure' criteria.
  • While mortality rates were 5.2% in the AKI group and 2.5% in the control group (p=0.09), this difference was not statistically significant.
  • Patients with AKI had significantly higher rates of low cardiac output syndrome, need for dialysis, and infection, along with longer mechanical ventilation duration and ICU stays.

Conclusions:

  • Acute kidney injury (AKI) is independently linked to a higher incidence of postoperative complications in pediatric cardiac surgery.
  • AKI was not found to be an independent predictor of mortality in this pediatric cardiac surgery cohort.
Abstract

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