Risk factors of acute kidney injury in children after cardiac surgery

Ji Hyun Lee, Ji Yoon Jung, Sun Woo Park, In Kyung Song, Eunhee Kim, Heesoo Kim, Jin-Tae Kim

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The objective of this retrospective study was to determine the risk factors for acute kidney injury (AKI), including albumin, in children who underwent cardiac surgery. In addition, we evaluated the association between preoperative serum albumin level and postoperative AKI in these patients. Methods: This retrospective study included 505 pediatric patients who underwent congenital cardiac surgery. Preoperative and perioperative risk factors for AKI, including serum albumin level, were assessed. AKI incidence within 7 postoperative days was determined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Multivariable logistic regression analysis was performed to evaluate the association between possible risk factors and postoperative AKI. Results: Of 505 pediatric patients, 185 (36.6%) developed postoperative AKI. The preoperative serum albumin level was associated with postoperative AKI (odds ratio [OR] 0.506, 95% confidence interval [CI] 0.325-0.788; P = 0.003). Other independent factors associated with AKI were age <12 months (OR 1.911, 95% CI 1.166-3.132; P = 0.007), preoperative pulmonary hypertension (OR 1.853, 95% CI 1.182-2.907; P = 0.01), and cardiopulmonary bypass (CPB) duration (OR 1.006, 95% CI 1.003-1.009; P = 0.002). Patients with AKI had higher incidence of postoperative complications, longer mechanical ventilation times, and more prolonged intensive care unit and hospital stays than patients without AKI. Conclusions: Preoperative serum albumin level, age <12 months, preoperative pulmonary hypertension, and CPB duration were associated with risk for postoperative AKI in children who underwent congenital cardiac surgery.

Original languageEnglish
Pages (from-to)1374-1382
Number of pages9
JournalActa Anaesthesiologica Scandinavica
Volume62
Issue number10
DOIs
StatePublished - 1 Nov 2018

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Acute Kidney Injury
Thoracic Surgery
Serum Albumin
Odds Ratio
Confidence Intervals
Cardiopulmonary Bypass
Pulmonary Hypertension
Retrospective Studies
Pediatrics
Incidence
Kidney Diseases
Artificial Respiration
Intensive Care Units
Albumins
Length of Stay
Logistic Models
Regression Analysis

Keywords

  • acute kidney injury
  • cardiac surgery
  • child
  • morbidity
  • serum albumin

Cite this

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title = "Risk factors of acute kidney injury in children after cardiac surgery",
abstract = "Background: The objective of this retrospective study was to determine the risk factors for acute kidney injury (AKI), including albumin, in children who underwent cardiac surgery. In addition, we evaluated the association between preoperative serum albumin level and postoperative AKI in these patients. Methods: This retrospective study included 505 pediatric patients who underwent congenital cardiac surgery. Preoperative and perioperative risk factors for AKI, including serum albumin level, were assessed. AKI incidence within 7 postoperative days was determined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Multivariable logistic regression analysis was performed to evaluate the association between possible risk factors and postoperative AKI. Results: Of 505 pediatric patients, 185 (36.6{\%}) developed postoperative AKI. The preoperative serum albumin level was associated with postoperative AKI (odds ratio [OR] 0.506, 95{\%} confidence interval [CI] 0.325-0.788; P = 0.003). Other independent factors associated with AKI were age <12 months (OR 1.911, 95{\%} CI 1.166-3.132; P = 0.007), preoperative pulmonary hypertension (OR 1.853, 95{\%} CI 1.182-2.907; P = 0.01), and cardiopulmonary bypass (CPB) duration (OR 1.006, 95{\%} CI 1.003-1.009; P = 0.002). Patients with AKI had higher incidence of postoperative complications, longer mechanical ventilation times, and more prolonged intensive care unit and hospital stays than patients without AKI. Conclusions: Preoperative serum albumin level, age <12 months, preoperative pulmonary hypertension, and CPB duration were associated with risk for postoperative AKI in children who underwent congenital cardiac surgery.",
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Risk factors of acute kidney injury in children after cardiac surgery. / Lee, Ji Hyun; Jung, Ji Yoon; Park, Sun Woo; Song, In Kyung; Kim, Eunhee; Kim, Heesoo; Kim, Jin-Tae.

In: Acta Anaesthesiologica Scandinavica, Vol. 62, No. 10, 01.11.2018, p. 1374-1382.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk factors of acute kidney injury in children after cardiac surgery

AU - Lee, Ji Hyun

AU - Jung, Ji Yoon

AU - Park, Sun Woo

AU - Song, In Kyung

AU - Kim, Eunhee

AU - Kim, Heesoo

AU - Kim, Jin-Tae

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: The objective of this retrospective study was to determine the risk factors for acute kidney injury (AKI), including albumin, in children who underwent cardiac surgery. In addition, we evaluated the association between preoperative serum albumin level and postoperative AKI in these patients. Methods: This retrospective study included 505 pediatric patients who underwent congenital cardiac surgery. Preoperative and perioperative risk factors for AKI, including serum albumin level, were assessed. AKI incidence within 7 postoperative days was determined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Multivariable logistic regression analysis was performed to evaluate the association between possible risk factors and postoperative AKI. Results: Of 505 pediatric patients, 185 (36.6%) developed postoperative AKI. The preoperative serum albumin level was associated with postoperative AKI (odds ratio [OR] 0.506, 95% confidence interval [CI] 0.325-0.788; P = 0.003). Other independent factors associated with AKI were age <12 months (OR 1.911, 95% CI 1.166-3.132; P = 0.007), preoperative pulmonary hypertension (OR 1.853, 95% CI 1.182-2.907; P = 0.01), and cardiopulmonary bypass (CPB) duration (OR 1.006, 95% CI 1.003-1.009; P = 0.002). Patients with AKI had higher incidence of postoperative complications, longer mechanical ventilation times, and more prolonged intensive care unit and hospital stays than patients without AKI. Conclusions: Preoperative serum albumin level, age <12 months, preoperative pulmonary hypertension, and CPB duration were associated with risk for postoperative AKI in children who underwent congenital cardiac surgery.

AB - Background: The objective of this retrospective study was to determine the risk factors for acute kidney injury (AKI), including albumin, in children who underwent cardiac surgery. In addition, we evaluated the association between preoperative serum albumin level and postoperative AKI in these patients. Methods: This retrospective study included 505 pediatric patients who underwent congenital cardiac surgery. Preoperative and perioperative risk factors for AKI, including serum albumin level, were assessed. AKI incidence within 7 postoperative days was determined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Multivariable logistic regression analysis was performed to evaluate the association between possible risk factors and postoperative AKI. Results: Of 505 pediatric patients, 185 (36.6%) developed postoperative AKI. The preoperative serum albumin level was associated with postoperative AKI (odds ratio [OR] 0.506, 95% confidence interval [CI] 0.325-0.788; P = 0.003). Other independent factors associated with AKI were age <12 months (OR 1.911, 95% CI 1.166-3.132; P = 0.007), preoperative pulmonary hypertension (OR 1.853, 95% CI 1.182-2.907; P = 0.01), and cardiopulmonary bypass (CPB) duration (OR 1.006, 95% CI 1.003-1.009; P = 0.002). Patients with AKI had higher incidence of postoperative complications, longer mechanical ventilation times, and more prolonged intensive care unit and hospital stays than patients without AKI. Conclusions: Preoperative serum albumin level, age <12 months, preoperative pulmonary hypertension, and CPB duration were associated with risk for postoperative AKI in children who underwent congenital cardiac surgery.

KW - acute kidney injury

KW - cardiac surgery

KW - child

KW - morbidity

KW - serum albumin

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U2 - 10.1111/aas.13210

DO - 10.1111/aas.13210

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