• Clin. Exp. Nephrol. · Aug 2011

    Predictors of acute kidney injury post-cardiopulmonary bypass in children.

    • Sidharth Kumar Sethi, Deepak Goyal, Dinesh Kumar Yadav, Umesh Shukla, Pyare Lal Kajala, V K Gupta, Vijay Grover, Pragati Kapoor, and Atul Juneja.
    • Department of Pediatrics, PGIMER and Associated RML Hospital, New Delhi 110001, India. sidsdoc@gmail.com
    • Clin. Exp. Nephrol. 2011 Aug 1;15(4):529-34.

    ObjectiveTo investigate the incidence, implicating factors and outcome of acute kidney injury (AKI) after cardiopulmonary bypass (CPB) in patients admitted to a pediatric cardiothoracic intensive care unit (ICU).Materials And MethodsDesignA retrospective review study.SettingA 10-bed cardiothoracic ICU.PatientsOne hundred and twenty-four children (<18 years of age) admitted to the cardiothoracic ICU following CPB between January 2007 and December 2009.MethodsAge, sex, diagnosis, baseline and post-surgery hemoglobin, total leukocyte count, platelet count and biochemistry were recorded. Baseline and postoperative urea (mg/dl), creatinine (mg/dl), urine output (ml/kg/h) and inotrope dose were also recorded daily. The duration of CPB was noted. Postoperative cardiac, renal, hepatic, neurologic and respiratory dysfunctions were recorded.ResultsSeven (5%) children developed AKI stage I, five children (4%) developed AKI stage II and two children developed AKI stage III (2%). All patients with AKI had a longer stay in hospital and increased mortality. Two children required dialysis for AKI and none developed chronic renal impairment. All patients with AKI stage III died during the ICU stay. Using stepwise regression, younger age (<1 year), weight <10 kg, pump failure, sepsis and duration of CPB >90 min were significant risk factors identified for developing AKI.ConclusionsAKI is common and occurred in 11% of our patients following CPB; however, AKI requiring renal replacement therapy is uncommon.

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