Abstract: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 i… Show more
“…Furthermore, 15 articles were excluded because they did not have the outcome of interest or were duplicate studies. Finally, 30 articles [ 9 – 13 , 26 – 50 ] were selected for the meta-analysis. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Thirty studies [ 9 – 13 , 26 – 50 ] reported the incidence rate of AKI. These studies were significantly heterogeneous ( I 2 = 98.169%, P < 0.001).…”
Background
Acute kidney injury (AKI) is a common complication of cardiac surgery. However, the incidence rate of AKI in patients with congenital heart disease (CHD) greatly varies between reports owing to the different definitions used for AKI. Therefore, this study was designed as a meta-analysis aimed at summarizing the incidence rate of AKI in patients with congenital heart disease (CHD) on the basis of different AKI criteria.
Methods
Studies published till April 24, 2020, on the incidence rate of AKI in patients with CHD, were retrieved from electronic databases and printed literature. To pool data from the included studies, the effect size, a combined statistics, was chosen and presented with the incidence rate and 95% confidence interval (CI). Heterogeneity was evaluated using
I
2
statistics and Cochran
Q
test. The incidence rates obtained from the subgroup analysis according to study location, type of surgery, type of cohort, age, and AKI criteria) were also evaluated to determine the correlation of AKI with these factors. Publication bias was estimated using the Egger test.
Results
Thirty studies, comprising 9925 patients with AKI who had CHD, were included. Overall, the pooled incidence rate of AKI in the patients with CHD was 38.4% (95% CI, 32.0–44.7%). However, the incidence rate was not significantly affected by gender, study location, type of surgery, type of cohort, and AKI criteria. Moreover, age was significantly associated with the incidence of AKI, and the incidence rate was higher in the patients aged < 1 month than in those aged 1 month to 18 years, < 18 years, and ≥ 18 years (
P
< 0.05).
Conclusions
In this study, the estimated incidence rate of AKI in patients with CHD was 38.4% and may be influenced by age. These findings highlight the importance of further investigation of the specific causes of and effective preventive measures for AKI.
“…Furthermore, 15 articles were excluded because they did not have the outcome of interest or were duplicate studies. Finally, 30 articles [ 9 – 13 , 26 – 50 ] were selected for the meta-analysis. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Thirty studies [ 9 – 13 , 26 – 50 ] reported the incidence rate of AKI. These studies were significantly heterogeneous ( I 2 = 98.169%, P < 0.001).…”
Background
Acute kidney injury (AKI) is a common complication of cardiac surgery. However, the incidence rate of AKI in patients with congenital heart disease (CHD) greatly varies between reports owing to the different definitions used for AKI. Therefore, this study was designed as a meta-analysis aimed at summarizing the incidence rate of AKI in patients with congenital heart disease (CHD) on the basis of different AKI criteria.
Methods
Studies published till April 24, 2020, on the incidence rate of AKI in patients with CHD, were retrieved from electronic databases and printed literature. To pool data from the included studies, the effect size, a combined statistics, was chosen and presented with the incidence rate and 95% confidence interval (CI). Heterogeneity was evaluated using
I
2
statistics and Cochran
Q
test. The incidence rates obtained from the subgroup analysis according to study location, type of surgery, type of cohort, age, and AKI criteria) were also evaluated to determine the correlation of AKI with these factors. Publication bias was estimated using the Egger test.
Results
Thirty studies, comprising 9925 patients with AKI who had CHD, were included. Overall, the pooled incidence rate of AKI in the patients with CHD was 38.4% (95% CI, 32.0–44.7%). However, the incidence rate was not significantly affected by gender, study location, type of surgery, type of cohort, and AKI criteria. Moreover, age was significantly associated with the incidence of AKI, and the incidence rate was higher in the patients aged < 1 month than in those aged 1 month to 18 years, < 18 years, and ≥ 18 years (
P
< 0.05).
Conclusions
In this study, the estimated incidence rate of AKI in patients with CHD was 38.4% and may be influenced by age. These findings highlight the importance of further investigation of the specific causes of and effective preventive measures for AKI.
“…The diagnosis of AKI is based on two functional markers, an increase of serum creatinine and a reduction of urinary excretion. Predictors of perioperative AKI in patients undergoing heart surgery include preoperative creatinine level, endstage renal disease, 2-2 phenotype of haptoglobin, advanced age, diabetes mellitus, congestive heart failure, generalized atherosclerosis, cardiovascular collapse, nitric oxide, cyanotic heart disease, duration of surgery and elevated postoperative lactate level [4][5][6][7][8][9]. In patients with severe AKI, oliguria and fluid accumulation, renal replacement therapy is the basic method of treatment [10].…”
Background: Acute kidney injury (AKI) is one of the serious postoperative complications in patients undergoing heart valve surgery. The aim of the present study was to identify selected biomarkers to predict AKI requiring renal replacement. Methods: A prospective study was conducted on a group of 751 patients undergoing heart valve surgery. The data on risk factors, preoperative complete blood count, course of operations and postoperative period was assessed. The primary endpoint at the 30-day follow-up was postoperative AKI requiring renal replacement therapy. The secondary end-point was death from all causes in patients with postoperative AKI requiring renal replacement. Results: The primary endpoint occurred in 46 patients. At multivariate analysis: age, red cell distribution width (RDW) and C-reactive protein remained independent predictors of the primary endpoint. Hemoglobin and RDW were associated with an increased risk of death. Conclusions: Elevated RDW is associated with a higher risk of postoperative AKI and death in patients with AKI. (Cardiol J XXXX; XX, X: xx-xx)
“…KPB ve hipotermi renal kan akımında azalma, hemodilüsyon ve renal tubuler hasara yol açan madde salınımı nedeniyle ABH açısından risk oluşturmaktadır (24) . Bununla beraber, uzamış KPB süresi de ABH gelişimi üzerine ilişkili bulunmuştur (25) . Serimizde de ABH gözlenen grupta, KPB süresinin uzun olması ve hipoterminin düşük olması diğer gruba kıyasla anlamlı fark yaratmış olup, literatürdeki bilgileri desteklemektedir.…”
Pediatrik kalp cerrahisi uygulanan hastalarda, postoperatif akut böbrek hasarının belirlenmesi ve mevcut hasarın derecesinin evrelenmesi için pRIFLE sınıflaması kullanılması ile bu hasta grubu ve böbrek hasarı olmayan hasta grupları arasında postoperatif sonuçların karşılaştırılması amaçlanmıştır. Hastalar ve Yöntem: Nisan 2012 ile Nisan 2013 tarihleri arasında kliniğimizde konjenital kalp hastalığı nedeniyle ameliyat edilen tüm hastalar geriye dönük olarak incelendi. Akut böbrek hasarının belirlenmesi ve evrelenmesi için pRIFLE kriterleri kullanıldı. Primer olarak önem verilen sonuçlar, postoperatif dönemde akut böbrek hasarı gelişen olguların pRIFLE kriterleri ile belirlenmesi, hasar derecesinin pRIFLE evreleri ile gösterilmesi, böbrek hasarı olguları ile böbrek hasarı olmayan olgular arasında operatif verilerin ve postoperatif sonuçların karşılaştırılması idi. Bulgular: Çalışmaya ardışık 105 hasta dahil edildi. Akut böbrek hasarı tespit edilen 45 (%42.9) hasta grup 1 olarak, diğerleri grup 2 olarak tanımlandı. Preoperatif verilerden ortalama yaş grup 1'de anlamlı olarak düşüktü (p= 0.001). Operatif verilerden kardiyopulmoner baypas süresi grup 1'de anlamlı olarak yüksekti (p= 0.04) ve hipotermi anlamlı olarak düşüktü (p= 0.001). Postoperatif dönemde, mortalite açısından gruplar arasında istatistiksel anlamlı fark gözlenmedi (p= 0.65). Hastaların mekanik ventilasyon ve yoğun bakım kalış süreleri, grup 1'de anlamlı olarak yüksek (sırasıyla p= 0.004 ve 0.04) iken, hastane kalış süreleri açısından gruplar arasında fark yoktu (p= 0.53). Sonuç: Pediatrik kalp cerrahisi uygulanan hastalarda postoperatif dönemde akut böbrek hasarı gelişme riski yüksektir ve bu durum postoperatif sonuçları etkilemektedir. Bu nedenle perioperatif dönemde bu hasardan korunma ve erken dönemde müdahale yönetiminin gerçekleştirilmesi için hasarın öngörüsünün yapılması amacıyla neredeyse maliyetsiz, kolay ve hızlı sonuç alınan pRIFLE kriterlerinin kullanılmasını önermekteyiz Anahtar Kelimeler: Akut böbrek hasarı; konjenital kalp hastalıkları; pRIFLE kriterleri
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
