Insuficiência renal aguda no contexto de cirurgia cardíaca pediátrica: fatores de risco e prognóstico. Proposta de um modelo preditivo

Cardoso, Bárbara; Laranjo, Sérgio; Gomes, Inês; Freitas, Isabel Cristina Martins de; Trigo, Conceição; Fragata, Isabel; Fragata, José; Pinto, Fátima F.

doi:10.1016/j.repc.2015.06.006

Cited by 9 publications

(7 citation statements)

References 11 publications

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“…In line with findings of other reports,[ 1 9 ] patients who developed AKI in our study had a higher baseline preoperative creatinine level. However, the association was not very strong and is not clinically significant (aOR = 0.47, P = 0.05).…”

Section: Discussionsupporting

confidence: 93%

“…Similar to Cardoso et al .,[ 9 ] we found that higher postoperative lactate level, a sign of hypoperfusion, is an independent risk factor for AKI confirming hypoperfusion as a proposed mechanism of AKI.…”

Section: Discussionsupporting

confidence: 60%

“…Our finding is in keeping with other studies showing that AKI increases duration of mechanical ventilation, ICU, and hospital length of stay. [ 9 17 18 ] Nevertheless, the difference for ICU and hospital length of stay was not statistically significant. It seems that factors other than AKI might affect these morbidities.…”

Section: Discussionmentioning

confidence: 91%

“…It is associated with increased morbidity and mortality. [ 5 6 7 8 ] It also increases duration of mechanical ventilation,[ 1 9 ] Intensive Care Unit (ICU) and hospital length of stay,[ 7 10 ] and resource utilization. [ 5 ] The increased mortality depends on severity of AKI.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors and outcome of acute kidney injury after congenital heart surgery: A prospective observational study

Amini

Abbaspour

Morovatdar

et al. 2017

Indian Journal of Critical Care Medicine

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Backgrounds and Aims:Acute kidney injury (AKI) is a frequent event after congenital heart surgery with increased mortality and morbidity. We investigated frequency, risk factors, and associated morbidity and mortality of AKI after pediatric cardiac surgery at a single institution.Methods:Children undergoing congenital heart surgery from March 2013 to February 2016 were assessed for development of AKI based on modified pediatric Risk, Injury, Failure, Loss, and End-stage renal disease criteria. They were also investigated for predictive risk factors, associated mortality, and morbidity including duration of mechanical ventilation, Intensive Care Unit (ICU), and hospital length of stay.Results:Five hundred and nineteen patients were recruited during the study period including 259 (49.9%) males and 260 (50.1%) females. AKI was seen in 150 (28.9%) patients including 101 (67.3%), 42 (28%), and 7 (4.7%) cases with risk, injury, and failure stages, respectively. Patients with AKI had longer ventilation time (P = 0.002), ICU (P = 0.05), and hospital (P = 0.56) stay. Mortality was seen in 31 (2.7%) and 44 (11.9%) patients with and without AKI, respectively (P = 0.01). After multivariable logistic regression, there was an association between AKI and preoperative abnormal levels of creatinine (adjusted odds ratio [aOR] = 0.47, 95% confidence interval [CI] 0.22–1.01; P = 0.05), presence of cyanotic heart disease (aOR = 1.97, 95% CI = 1.15–3.2; P = 0.01), duration of surgery (aOR = 1.05/10 min, 95% CI = 1.01–1.08; P = 0.007), and elevated lactate level (aOR = 1.14, 95% CI = 1.03–1.3; P = 0.01).Conclusion:The presence of cyanotic heart disease, duration of surgery, elevated postoperative lactate level, and likely preoperative creatinine level were independent risk factors for the development of AKI after congenital heart surgery.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Risk factors and outcome of acute kidney injury after congenital heart surgery: A prospective observational study

Amini

Abbaspour

Morovatdar

et al. 2017

Indian Journal of Critical Care Medicine

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“…All patients with AKI recovered their kidney function at the time of discharge, with normal blood pressure. However, their study did not define the postoperative recovery course of their patients, although other studies did not have significant numbers of stage III AKI patients with spontaneous resolution [12,16,17]. We reported a slightly different observation: the majority (85%) of our patients were in stages II and III AKI according to the m-KDIGO classification, and 94% showed spontaneous resolution.…”

Section: Discussionmentioning

confidence: 55%

Acute Kidney Injury after Congenital Heart Disease Surgery: A Single-Center Experience in a Low- to Middle-Income Country

Ali¹,

Khan²,

Mirza³

et al. 2020

Cureus

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Value of Preoperative Creatine Kinase-MB for Prediction of Acute Kidney Injury in Congenital Cardiac Surgery Using Cardiopulmonary Bypass: a prospective study

Gomaa

Shaarawy

Almetainy

et al. 2021

Egyptian Journal of Anaesthesia

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Background: Acute kidney injury (AKI) is a common complication associated with cardiac surgery with cardiopulmonary bypass (CPB) with a deleterious effect on morbidity and mortality. The current study aimed to determine the efficacy of preoperative creatine kinase-MB (CK-MB) level for the prediction of occurrence and severity of AKI. Settings and Design: This study was a prospective cross-sectional observational study. Methods: The study was carried out on 74 pediatric patients aged less than 18 years scheduled for elective congenital cardiac surgery using CPB. The prevalence of AKI within 72 hours was defined according to the three-stage Acute Kidney Injury Network (AKIN) criteria. Logistic regression analysis was done and adjusted odds ratio (OR) and confidence intervals at 95% (95% CI) were calculated. Results: AKI had developed in 25 patients (33.78%) by the second postoperative day. Patients who developed AKI had higher mean levels of preoperative CK-MB compared with patients without AKI (P = 0.002). Lower mean age, longer duration of surgery, bypass time, and crossclamp time were independently associated with AKI (p < 0.015, 0.001, 0.001and 0.001, respectively). Patients who developed AKI had a longer duration of mechanical ventilation (MV) (OR 1.3, 95% CI 1.147-1.691) so; they required longer intensive care unit (ICU) stay. Conclusion: CK-MB can be a useful biomarker for detecting early AKI after congenital cardiac surgery and predicting adverse clinical outcomes.

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Insuficiência renal aguda no contexto de cirurgia cardíaca pediátrica: fatores de risco e prognóstico. Proposta de um modelo preditivo

Cited by 9 publications

References 11 publications

Risk factors and outcome of acute kidney injury after congenital heart surgery: A prospective observational study

Risk factors and outcome of acute kidney injury after congenital heart surgery: A prospective observational study

Acute Kidney Injury after Congenital Heart Disease Surgery: A Single-Center Experience in a Low- to Middle-Income Country

Value of Preoperative Creatine Kinase-MB for Prediction of Acute Kidney Injury in Congenital Cardiac Surgery Using Cardiopulmonary Bypass: a prospective study

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