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November 10, 2016PLoS ONEOpen Access

Risk Factors for Acute Kidney Injury after Congenital Cardiac Surgery in Infants and Children: A Retrospective Observational Study

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Key result

A hemoglobin concentration increase of >3 g/dl on postoperative day 1 was independently associated with a significantly higher risk of acute kidney injury (adjusted OR 6.94) compared to no increase.

Population

220 patients who underwent congenital cardiac surgery between January and December 2012 at a single center.

Design

Cohort

Follow-up

7 days postoperatively

Authors

SPSun-Kyung ParkYonsei UniversityMHMin HurAjou UniversityEKEun‐Hee KimDong-A University

Discussion

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Overview

May support targeting anesthesia parameters to reduce pediatric postoperative AKI; hypothesis-generating pending prospective validation.

Study Design

Type

Cohort (n=220)

Multicenter

No

Structured PICO

P
Population
220 pediatric patients (aged 10 days to 19 years) undergoing elective congenital cardiac surgery, evaluated for postoperative acute kidney injury within 7 days.
O
Outcome
Incidence of Acute Kidney Injury (AKI) within 7 days postoperatively determined using KDIGO criteria

Main Result

Odds Ratio: 6.94 (95% CI 2.33–20.69)

Absolute Event Rate: 78.6% vs 26.4%

p-value: p=0.001

Younger age, longer cardiopulmonary bypass time, low preoperative hemoglobin, and significant postoperative hemoconcentration are independent risk factors for acute kidney injury following congenital cardiac surgery.

Limitations

  • Retrospective study design precludes causal inference
  • Single-center study limits external validity
  • Potential inaccuracy of AKI diagnosis in neonates due to baseline creatinine fluctuations
  • Urine output criteria were not used to diagnose AKI

Cite This Study

Park et al. (2016) conducted a cohort in Congenital heart disease requiring cardiac surgery (n=220). Hemoglobin concentration increase (>3 g/dl) on postoperative day 1 vs. No increase or decrease in hemoglobin concentration was evaluated on Incidence of acute kidney injury (AKI) within 7 days postoperatively according to KDIGO criteria (adjusted OR 6.94, 95% CI 2.33-20.69, p=0.001). A hemoglobin concentration increase of >3 g/dl on postoperative day 1 was independently associated with a significantly higher risk of acute kidney injury (adjusted OR 6.94) compared to no increase.

synapsesocial.com/papers/6a97cb655a0f36424c366affhttps://doi.org/10.1371/journal.pone.0166328
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Risk Factors and Outcomes of Acute Kidney Injury in Children With Congenital Heart Disease Following Cardiac Surgery2026
  2. 2Risk factors of acute kidney injury in children after cardiac surgery2018 · 34 citations
  3. 3Incidence and risk factors for acute kidney injury in children with congenital heart disease undergoing cardiac surgery in a tertiary care center.2023
  4. 4297 Exploring Risk Factors for Acute Kidney Injury in Patients Undergoing Cardiac Surgery2024 · 3 citations
  5. 5Risk Factors and Consequences of Acute Kidney Injury After Noncardiac Surgery in Children2022 · 16 citations