Risk factors for postoperative dialysis in operated congenital heart patients undergoing cardiopulmonary bypass

BACKGROUND: Postoperative acute kidney injury is a common phenomenon in patients with congenital heart. Peritoneal dialysis is almost always the first choice in operated congenital heart patients when renal replacement therapy is required. Several factors have been identified that may cause renal damage in this patient group. In this study, we investigated the risk factors for postoperative dialysis in congenital heart patients younger than six months who underwent open-heart surgery.METHODS: We studied infants younger than six months who had undergone open-heart surgery in our pediatric cardiovascular surgery clinic within the past year and included patients who underwent cardiopulmonary bypass. The primary outcome of our study was to evaluate the factors influencing the need for postoperative dialysis.RESULTS: We identified 57 patients who met the criteria. Surgery weight and surgery age were significantly lower in the peritoneal dialysis group. Preoperative human albumin level was significantly lower (P=0.002), and duration of cardiopulmonary bypass was significantly higher in the peritoneal dialysis group. As expected, mortality was significantly higher in peritoneal dialysis group.CONCLUSIONS: In this study, we evaluated the predictive factors in infants undergoing cardiopulmonary bypass. Lower surgery weight and age and longer cardiopulmonary bypass time were associated with the need for postoperative dialysis. We also demonstrated for the first time a relationship between low preoperative albumin and the need for postoperative dialysis. Our current findings suggest that a more rigorous approach to nutrition and salt-water balance may have beneficial clinical effects in this patient population.