Cardiac surgery-associated acute kidney injury in a developing country: Prevalence, risk factors and outcome

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Ekure, E.N.
Esezobor, C.I.
Sridhar, A.
Vasudevan, J.
Subramanyan, R.
Cherian, K.M.
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Wolters Kluwer Medknow Publications
Little is known about cardiac surgery-associated acute kidney injury (CS-AKI) in children in developing regions of the world. The study aimed to determine the prevalence of CS- AKI, associated factors and its impact on mortality and utilization of hospital services. The hospital records of children aged 0–17 years who underwent CS at an Indian hospital were reviewed. CS-AKI was defined as a rise in serum creatinine of ≥0.3 mg/dL in any 48 h and or by urine output <0.5 mL/kg/h for an 8-h period in the first five days after CS. The study included 323 children with a median age of one year (0.04–17), of whom 22 (6.8%) were neonates and 18.3% had a single ventricle. About 60% of the children had Risk Adjusted Congenital Heart Surgery–I category 1 or 2 interventions. CS-AKI occurred in 39 children (12.1%). Factors associated with CS-AKI were sepsis and intra- and post-operative hypotension. In-hospital mortality was six-fold higher in children who developed CS-AKI. CS-AKI was associated with two to three days more of mechanical ventilation and Intensive care unit stay. CS-AKI occurs in children in developing countries, but at a lower frequency mainly due to the predominance of post-neonatal children undergoing less-complex CSs. CS-AKI was associated with higher in-hospital mortality and increased utilization of hospital services. Factors associated with CS-AKI included intra- and post-operative hypotension and sepsis.
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Cardiac surgery , Acute kidney injury , developing country , Prevalence , Risk factors , Outcome , Congenital heart disease , Research Subject Categories::MEDICINE
Ekure EN, Esezobor CI, Sridhar A, Vasudevan J, Subramanyan R, Cherian KM. Cardiac surgery-associated acute kidney injury in a developing country: Prevalence, risk factors and outcome. Saudi J Kidney Dis Transpl. 2015 May-Jun;26(3):489-96.