Key result
Preoperative albumin and prealbumin levels were not associated with decreased eGFR after pediatric cardiac surgery, whereas longer aortic cross-clamp time was significantly associated with decreased eGFR.
Why the study?
It was unknown whether the development of acute kidney injury is associated with preoperative albumin/prealbumin levels and other clinical features in pediatric patients undergoing open-heart surgery for congenital heart disease.
Are preoperative albumin and prealbumin levels associated with acute kidney injury in pediatric patients undergoing open-heart surgery for congenital heart disease?
Cohort (n=100)
No
Are preoperative albumin and prealbumin levels associated with acute kidney injury in pediatric patients undergoing open-heart surgery for congenital heart disease?
Preoperative albumin and prealbumin levels are not associated with postoperative acute kidney injury in pediatric congenital heart surgery, though longer aortic cross-clamp time is a risk factor.
Preoperative albumin/prealbumin levels should not guide AKI risk assessment in pediatric cardiac surgery; leaves open ACCT as a potential modifiable factor.
Objectives: This study aimed to evaluate whether the development of acute kidney injury (AKI) was associated with preoperative albumin/prealbumin levels and other clinical features in pediatric patients who underwent open-heart surgery for congenital heart disease. Patients and Methods: In this retrospective cohort, patients aged between 1 – 60 months who underwent open-heart surgery (complete correction surgery) with a diagnosis of congenital heart disease at the XXXXXX, between January 1, 2018 - December 31, 2020, were retrospectively included (n = 100). Patient demographics, diagnoses, surgical characteristics, and laboratory findings were recorded and analyzed. Results: Mean age was 13.63 ± 12.05 (range 1.5 - 60) months. eGFR was decreased by more than 50% in 13% of the cases. Compared to the preoperative period, it was found that urea (24th and 48th hour) and creatinine levels increased significantly (p< 0.001, for each), and eGFR decreased significantly in the postoperative period (p< 0.001). Linear regression for eGFR value revealed that longer aortic cross-clamp time (ACCT) was associated with a greater decrease in eGFR (p= 0.046). Other variables included in the model, age (p= 0.128), gender (p= 0.358), RACHS (p= 0.865), body mass index (p= 0.862), prealbumin (p= 0.313), albumin (p= 0.806) and duration of cardiopulmonary bypass (p= 0.921) were found to be non-significant. Conclusion: While there was no relationship between eGFR and preoperative albumin/prealbumin levels in patients who underwent cardiac surgery due to congenital heart disease, longer ACCT was found to be associated with decreased eGFR.
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Işıldak et al. (2021) conducted a cohort in Congenital heart disease (n=100). Preoperative albumin and prealbumin levels was evaluated on Decrease in estimated glomerular filtration rate (eGFR) (p=0.806). Preoperative albumin and prealbumin levels were not associated with decreased eGFR after pediatric cardiac surgery, whereas longer aortic cross-clamp time was significantly associated with decreased eGFR.
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