Chronic kidney disease following pediatric cardiac surgery: a systematic review and meta-analysis

BACKGROUND: Chronic kidney disease (CKD) is a potential long-term complication in children undergoing cardiac surgery. With improved survival rates in this population, attention has shifted toward long-term outcomes, yet the true burden of CKD remains unclear due to limited data. OBJECTIVES: To determine the pooled prevalence of chronic kidney disease among pediatric patients with a history of cardiac surgery. MATERIALS AND METHODS: A systematic literature search was conducted in PubMed, Scopus, and Web of Science from inception to March 1, 2025. Eligible studies included those reporting CKD prevalence in patients under 18 years of age who had undergone any type of cardiac surgery. We performed this systematic review and meta-analysis following PRISMA guidelines and Cochrane Collaboration recommendations using a random-effects model. Pooled prevalence estimates were calculated with 95% confidence intervals (95% CI). RESULTS: Data from five prospective studies involving 1002 pediatric patients were included. The studies were published between 2016 and 2022 and conducted in Canada, France, the United States, and Belgium. The pooled prevalence of CKD was 16% (95% CI: 9.0-26.0%), with moderate heterogeneity across studies (I² = 49.5%, p = 0.09). Sensitivity analysis confirmed the stability of the pooled estimate. CONCLUSIONS: The findings of this analysis highlight the need for long-term renal monitoring in this population, although further high-quality studies with standardized definitions and extended follow-up are warranted to confirm and refine these estimates.