Development of acute kidney injury following pediatric cardiac surgery

Sharma, Aditya; Chakraborty, Ronith; Sharma, Katyayini; Sethi, Sidharth Kumar; Raina, Rupesh

doi:10.23876/j.krcp.20.053

Cited by 19 publications

(24 citation statements)

References 57 publications

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“…patients. 4 We argue that existence of any imbalance in these postoperative risk factors for AKI might have confounded interpretation of their results.…”

Section: O R R E S P O N D E N C Ementioning

confidence: 90%

“…It is generally believed that AKI occurring within the first 48 h after surgery is mainly associated with underlying health and intraoperative factors, whereas AKI occurring after 48 h is significantly related to postoperative complications and use of nephrotoxic drugs. In available literature, postoperative low cardiac output syndrome, sepsis, hemodynamic instability, reoperation and exposure to diuretics, vasopressors, gentamycin and nonsteroidal anti‐inflammatory drugs have been significantly associated with an increased risk of postoperative AKI in pediatric cardiac surgery patients 4 . We argue that existence of any imbalance in these postoperative risk factors for AKI might have confounded interpretation of their results.…”

mentioning

confidence: 83%

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Renoprotective effect of intraoperative dexmedetomidine in pediatric cardiac surgery patients: Comment

Liu

Xue

2021

Pediatric Anesthesia

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“…patients. 4 We argue that existence of any imbalance in these postoperative risk factors for AKI might have confounded interpretation of their results.…”

Section: O R R E S P O N D E N C Ementioning

confidence: 90%

mentioning

confidence: 83%

Renoprotective effect of intraoperative dexmedetomidine in pediatric cardiac surgery patients: Comment

Liu

Xue

2021

Pediatric Anesthesia

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“…Neonates and infants undergoing cardiac surgery are among the highest risk patients for developing AKI ( 22 , 23 ). This results from the complex interaction of a multitude of risk factors including but not limited to low cardiac output, single ventricle physiology, ischemic-reperfusion injury, fluid overload (FO), and nephrotoxic medication (NTX) receipt ( 17 , 24 , 25 ).…”

Section: Epidemiology Risk Factors and Outcomes Of Neonatal Akimentioning

confidence: 99%

Neonatal Acute Kidney Injury

et al. 2022

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Acute kidney injury (AKI) is a common occurrence in the neonatal intensive care unit (NICU). In recent years, our knowledge of the incidence and impact of neonatal AKI on outcomes has expanded exponentially. Neonatal AKI has been shown to be associated with adverse outcomes including increased length of mechanical ventilation, prolonged length of stay, and rise in mortality. There has also been increasing work suggesting that neonates with AKI are at higher risk of chronic kidney disease (CKD). In the past, AKI had been defined multiple ways. The utilization of the neonatal modified Kidney Disease: Improving Global Outcomes (KDIGO) criteria as the standard definition for neonatal AKI in research and clinical care has driven the advances in our understanding of neonatal AKI over the last 10 years. This definition has allowed researchers and clinicians to better understand the incidence, risk factors, and outcomes associated with neonatal AKI across populations through a multitude of single-center studies and the seminal, multicenter Assessment of Worldwide Acute Kidney Injury Epidemiology in Neonates (AWAKEN) study. As the impacts of neonatal AKI have become clear, a shift in efforts toward identifying those at highest risk, protocolizing AKI surveillance, improving prevention and diagnosis, and expanding kidney support therapy (KST) for neonates has occurred. These efforts also include improving risk stratification (identifying high risk populations, including those with nephrotoxic medication exposure) and diagnostics (novel biomarkers and diagnostic tools). Recent work has also shown that the targeted use of methylxanthines may prevent AKI in a variety of high-risk populations. One of the most exciting developments in neonatal AKI is the advancement in technology to provide KST to neonates with severe AKI. In this comprehensive review we will provide an overview of recent work and advances in the field of neonatal AKI. This will include a detailed review of (1) the definition of neonatal AKI, (2) the epidemiology, risk factors, and outcomes associated with neonatal AKI, (3) improvements in risk stratification and diagnostics, (4) mitigation and treatment, (5) advancements in the provision of KST to neonates, and (6) the incidence and risk of subsequent CKD.

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“…The diagnosis of AKI currently relies on biochemical and early disease indicators [ 10 , 11 ]. Blood biochemical indicators and markers cannot fully reflect the functional status of a unilateral kidney.…”

Section: Introductionmentioning

confidence: 99%

Predicting the Risk of Acute Kidney Injury in Patients After Percutaneous Coronary Intervention (PCI) or Cardiopulmonary Bypass (CPB) Surgery: Development and Assessment of a Nomogram Prediction Model

Wang

et al. 2021

Med Sci Monit

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Background We sought to create a model that incorporated ultrasound examinations to predict the risk of acute kidney injury (AKI) after percutaneous coronary intervention (PCI) or cardiopulmonary bypass (CPB) surgery. Material/Methods A total of 292 patients with AKI after PCI or CPB surgery were enrolled for the study. Afterwards, treatment-related information, including data pertaining to ultrasound examination, was collected. A random forest model and multivariate logistic regression analysis were then used to establish a predictive model for the risk of AKI. Finally, the predictive quality and clinical utility of the model were assessed using calibration plots, receiver-operating characteristic curve, C-index, and decision curve analysis. Results Predictive factors were screened and the model was established with a C-index of 0.955 in the overall sample set. Additionally, an area under the curve of 0.967 was obtained in the training group. Moreover, decision curve analysis also revealed that the prediction model had good clinical applicability. Conclusions The prediction model was efficient in predicting the risk of AKI by incorporating ultrasound examinations and a number of factors. Such included operation methods, age, congestive heart failure, body mass index, heart rate, white blood cell count, platelet count, hemoglobin, uric acid, and peak intensity (kidney cortex as well as kidney medulla).

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Development of acute kidney injury following pediatric cardiac surgery

Cited by 19 publications

References 57 publications

Renoprotective effect of intraoperative dexmedetomidine in pediatric cardiac surgery patients: Comment

Renoprotective effect of intraoperative dexmedetomidine in pediatric cardiac surgery patients: Comment

Neonatal Acute Kidney Injury

Predicting the Risk of Acute Kidney Injury in Patients After Percutaneous Coronary Intervention (PCI) or Cardiopulmonary Bypass (CPB) Surgery: Development and Assessment of a Nomogram Prediction Model

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