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Acute renal failure associated with cardiac surgery
F J Gómez-Campderá1, E Maroto-Alvaro, M Galiñanes
1Department of Pediatric Nephrology, Hospital General Gregorio Marañón, Madrid, Spain.
Insights
Acute renal failure (ARF) affects 9% of pediatric cardiac surgery patients, with 58% mortality. Management requires specialized pediatric critical care expertise for improved outcomes.
Area of Science:
- Pediatric Nephrology
- Pediatric Cardiology
- Critical Care Medicine
Background:
- Acute renal failure (ARF) is a significant complication in pediatric patients undergoing cardiac surgery.
- Understanding the incidence, management strategies, and outcomes of ARF in this vulnerable population is crucial.
Purpose of the Study:
- To determine the incidence of ARF in children post-cardiac surgery.
- To describe the management approaches, including dialysis, for pediatric ARF.
- To analyze the outcomes and mortality associated with ARF in this cohort.
Main Methods:
- Retrospective analysis of 156 pediatric patients undergoing cardiac surgery over a 3-year period.
- Identification of patients who developed ARF based on defined criteria.
- Review of patient demographics, ARF type (prerenal vs. renal), treatment modalities (including peritoneal dialysis), complications, and mortality.
Main Results:
- Fourteen (9%) of 156 patients developed ARF, with ages ranging from 2 days to 15 years.
- Prerenal failure occurred in 6 patients, and renal failure in 8 patients.
- Peritoneal dialysis was used in 58% of ARF cases; neurologic and respiratory complications were common.
- The overall mortality rate was 58%, linked to the primary cardiac condition and multi-organ complications.
Conclusions:
- Pediatric ARF following cardiac surgery carries a high incidence and mortality rate.
- Effective management necessitates experienced personnel, ideally with pediatric critical care training.
- Multifactorial complications significantly influence patient outcomes, highlighting the need for comprehensive care.
Abstract:
We present the incidence, management and outcome of acute renal failure (ARF) in children who underwent cardiac surgery. Fourteen (9%) from a total of 156 children developed ARF in our hospital in a 3-year period. Patients were aged 2 days to 15 years. Prerenal failure was present in 6 and renal type in the remaining 8 children. Peritoneal dialysis treatment was utilized in 58% of patients. Neurologic and respiratory complications were present. Mortality rate was 58% and related to underlying pathology and to complications in other organs. The management of these patients must be by competent personnel preferably trained in pediatrics.