Long-term outcome for children with acute renal failure following cardiac surgery

Shaw, Nicholas; Brocklebank, J T; Dickinson, D F; Wilson, Neil; Walker, Duncan R.

doi:10.1016/0167-5273(91)90211-7

Cited by 79 publications

(54 citation statements)

References 9 publications

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“…The damage induced by subclinical or manifested episodes of AKI may produce irreversible loss of renal mass with deleterious effects on overall renal function. In follow-up studies of pediatric AKI, the incidence of CKD ranges from 27% to 67% (8,22). Mammen et al demonstrated a 10% incidence of CKD 1-3 years after AKI in a critically ill population (including postoperative cardiac patients) according to a standardized AKI definition/ classification system (12).…”

Section: Discussionmentioning

confidence: 99%

Follow-Up Renal Assessment of Injury Long-Term After Acute Kidney Injury (FRAIL-AKI)

Cooper

Claes

Goldstein

et al. 2016

Clinical Journal of the American Society of Nephrology

113

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Background and objectives Novel urinary kidney damage biomarkers detect AKI after cardiac surgery using cardiopulmonary bypass (CPB-AKI). Although there is growing focus on whether AKI leads to CKD, no studies have assessed whether novel urinary biomarkers remain elevated long term after CPB-AKI. We assessed whether there was clinical or biomarker evidence of long-term kidney injury in patients with CPB-AKI.Design, setting, participants, & measurements We performed a cross-sectional evaluation for signs of chronic kidney injury using both traditional measures and novel urinary biomarkers in a population of 372 potentially eligible children (119 AKI positive and 253 AKI negative) who underwent surgery using cardiopulmonary bypass for congenital heart disease at Cincinnati Children's Hospital Medical Center between 2004 and 2007. A total of 51 patients (33 AKI positive and 18 AKI negative) agreed to long-term assessment. We also compared the urinary biomarker levels in these 51 patients with those in healthy controls of similar age.Results At long-term follow-up (mean duration6SD, 760.98 years), AKI-positive and AKI-negative patients had similarly normal assessments of kidney function by eGFR, proteinuria, and BP measurement. However, AKI-positive patients had higher urine concentrations of IL-18 (48.5 pg/ml versus 20.3 pg/ml [P=0.01] and 20.5 pg/ml [P,0.001]) and liver-type fatty acid-binding protein (L-FABP) (5.9 ng/ml versus 3.9 ng/ml [P=0.001] and 3.2 ng/ml [P,0.001]) than did AKI-negative patients and healthy controls.Conclusions Novel urinary biomarkers remain elevated 7 years after an episode of CPB-AKI in children. However, there is no conventional evidence of CKD in these children. These biomarkers may be a more sensitive marker of chronic kidney injury after CPB-AKI. Future studies are needed to understand the clinical relevance of persistent elevations in IL-18, kidney injury molecule-1, and L-FABP in assessments for potential long-term kidney consequences of CPB-AKI.

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Section: Discussionmentioning

confidence: 99%

Follow-Up Renal Assessment of Injury Long-Term After Acute Kidney Injury (FRAIL-AKI)

Cooper

Claes

Goldstein

et al. 2016

Clinical Journal of the American Society of Nephrology

113

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“…The incidence of acute renal failure in these infants has been reported in up to 9% 1,[4][5][6][7][8] , and this association has been related to high morbidity and mortality. Acute renal failure in these patients usually has a multifactorial character 2,4 , and its more frequent manifestations are as follows: acute cardiac failure, reduction in diuresis, elevation in the serum levels of urea and creatinine, and a very positive hydric balance.…”

Section: Discussionmentioning

confidence: 99%

“…It occurs in up to 9% of the children undergoing this type of intervention [1][2][3][4][5][6][7] . In most cases, acute renal failure is accompanied by either oliguria or anuria and is related to low output failure.…”

mentioning

confidence: 99%

“…The treatment for acute renal failure includes, in addition to severe fluid restriction and use of diuretics, removal of fluids through dialysis or hemofiltration, or both [5][6][7] . Recent evidence suggests that active fluid removal in patients with acute renal failure and low cardiac output after cardiopulmonary surgery may improve hemodynamic variables 8,9 .…”

mentioning

confidence: 99%

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Outcome of acute renal failure associated with cardiac surgery in infants

Romão¹,

Fuzissima²,

Vidonho³

et al. 2000

Arq. Bras. Cardiol.

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“…In addition, several adult studies have demonstrated a dose-response relationship between AKI and CKD, including a higher risk of CKD in those with more severe AKI and also in those with repeated episodes of AKI [35][36][37]. Several pediatric observational studies have also shown a high proportion of CKD in survivors of AKI, ranging from 10 to 69%, but these studies have focused on populations without primary kidney disease [38][39][40][41][42][43][44]. Although the etiology of AKI varies in most of these studies, Menon and colleagues identified that nephrotoxic AKI in children increases the risk of CKD at 6 months of follow-up [44].…”

Section: Aki and Ckd Associationmentioning

confidence: 99%

Acute kidney injury in children with sickle cell disease—compounding a chronic problem

2017

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In an article recently published in Pediatric Nephrology, Baddam and colleagues discuss the relatively underreported clinical problem of repeated episodes of acute kidney injury (AKI) in children with sickle cell disease (SCD). Their report is a cautionary note about the importance of repeated kidney injury on the background of underlying chronic kidney injury and its potential implications on long-term kidney outcome. In children and adults with SCD, this includes the effects of repeated vaso-occlusive crises and the management of these painful episodes with non-steroidal anti-inflammatory drugs. Here we review the scope of kidney involvement in SCD in children and discuss the potential short-and long-term consequences of AKI in children with SCD.

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Long-term outcome for children with acute renal failure following cardiac surgery

Cited by 79 publications

References 9 publications

Follow-Up Renal Assessment of Injury Long-Term After Acute Kidney Injury (FRAIL-AKI)

Follow-Up Renal Assessment of Injury Long-Term After Acute Kidney Injury (FRAIL-AKI)

Outcome of acute renal failure associated with cardiac surgery in infants

Acute kidney injury in children with sickle cell disease—compounding a chronic problem

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