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Acute and Chronic Kidney Disease Following Congenital Heart Surgery: A Review

Jacqueline N Khuong1, Thomas G Wilson1, Ajay J Iyengar1

  • 1Heart Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, Faculty of Medicine, University of Melbourne, Melbourne, Australia.

The Annals of Thoracic Surgery
|December 14, 2020
PubMed

Insights

Children who experience acute kidney injury after congenital heart surgery may be at higher risk for developing chronic kidney disease later in life. Further research is needed to prevent kidney injury and improve long-term outcomes.

Area of Science:

  • Pediatric Cardiology
  • Nephrology
  • Critical Care Medicine

Background:

  • Chronic kidney disease (CKD) is increasingly prevalent in adults with congenital heart disease (CHD).
  • A significant number of children undergoing congenital heart surgery develop acute kidney injury (AKI) postoperatively.
  • The link between childhood AKI post-cardiac surgery and subsequent CKD development remains unclear.

Purpose of the Study:

  • To investigate the association between acute kidney injury following pediatric congenital heart surgery and the development of chronic kidney disease.
  • To synthesize current research on the long-term renal outcomes of children experiencing AKI after cardiac procedures.

Main Methods:

  • A systematic literature search was conducted across three electronic databases.
  • Studies exploring the relationship between AKI after congenital heart surgery in children and progression to CKD were identified and reviewed.
  • A total of 212 articles were initially screened, with 7 selected for detailed analysis.

Main Results:

  • The review suggests a probable association between acute kidney injury in pediatric patients undergoing congenital heart surgery and the subsequent development of chronic kidney disease.
  • Evidence indicates a potential pathway from perioperative AKI to long-term renal impairment in this vulnerable population.

Conclusions:

  • A likely association exists between AKI in children undergoing congenital heart surgery and progression to CKD.
  • Further research is recommended to identify and mitigate factors contributing to postoperative AKI in neonates, infants, and children undergoing cardiac surgery.
  • Improved targeted follow-up protocols for renal function monitoring and a universal definition for AKI and CKD are crucial for better detection and research advancement.
Abstract

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