Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul;36(7):1923-1929.
doi: 10.1007/s00467-020-04890-z. Epub 2021 Jan 25.

Evaluation of neonatal acute kidney injury after critical congenital heart disease surgery

Serdar Beken  1 , Burcu Bulum Akbulut  2 , Eda Albayrak  3 , Bengisu Güner  4 , Yasemin Ünlü  3 , Bahar Temur  5 , Selim Aydin  5 , Ender Ödemiş  6 , Ersin Erek  5 , Ayşe Korkmaz  7
Affiliations

Evaluation of neonatal acute kidney injury after critical congenital heart disease surgery

Serdar Beken et al. Pediatr Nephrol. 2021 Jul.

Abstract

Background: Acute kidney injury (AKI) is a common complication of congenital heart diseases (CHDs) after cardiac surgery. This study aimed to define the frequency and critical course, risk factors and short-term outcomes of AKI in postoperative CHD neonates.

Methods: Postoperatively followed term CHD newborn infants were enrolled in the study. Infants with congenital anomalies of the urinary tract and other major congenital anomalies were excluded. Neonatal modified KDIGO criteria were used to assess AKI.

Results: A total of 199 postoperatively followed newborn infants were included in the study. Acute kidney injury was detected in 71 (35.6%) patients. Of these patients, 24 (33.8%) were in stage 1, 14 (19.7%) in stage 2, and 33 (46.5%) in stage 3. Acute kidney injury occurred within the first week (median 1 day [IQR 1-2 days]) of cardiac surgery in 93% of the patients. The duration of invasive respiratory support and extracorporeal membrane oxygenation (ECMO) and mortality were significantly higher in stage 3 patients. Higher vasoactive-inotropic score (OR, 1.02; 95% CI, 1.0-1.04; p = 0.008) and receiving ECMO (OR, 7.9; 95% CI, 2.6-24.4; p = 0.001) were associated with risk for the development of AKI. The mortality rate was 52.1% in the AKI (+) patients, and having AKI (OR 7.1; 95% CI, 3.5-14.18) was significantly associated with mortality.

Conclusion: Acute kidney injury, a common early complication after critical neonatal CHD cardiac surgery, is associated with increased morbidity and mortality. Stage 3 AKI is associated with significantly higher mortality rates.

Keywords: Acute kidney injury; Congenital heart disease; KDIGO; Neonatal AKI; Neonate; Pediatrics.

PubMed Disclaimer

References

    1. Centers for Disease Control and Prevention (CDC) (2010) Racial differences by gestational age in neonatal deaths attributable to congenital heart defects---United States, 2003-2006. MMWR Morb Mortal Wkly Rep 59:1208–1211
    1. Abouk R, Grosse SD, Ailes EC, Oster ME (2017) Association of US state implementation of newborn screening policies for critical congenital heart disease with early infant cardiac deaths. JAMA 318:2111–2118 - DOI
    1. Nada A, Bonachea EM, Askenazi D (2017) Acute kidney injury in the fetus and neonate. Semin Fetal Neonatal Med 22:90–97 - DOI
    1. Selewski DT, Charlton JR, Jetton JG, Guillet R, Mhanna MJ, Askenazi DJ, Kent AL (2015) Neonatal acute kidney injury. Pediatrics 136:e463–e473 - DOI
    1. Jetton JG, Boohaker LJ, Sethi SK, Wazir S, Rohatgi S, Soranno DE, Chisthti AS, Woroniecki R, Mammen C, Swanson JR, Sridhar S, Wong CS, Kupferman JC, Griffin RL, Askenazi DJ, Neonatal Kidney Collaborative (NKC) (2017) Incidence and outcomes of neonatal acute kidney injury (AWAKEN): a multicentre, multinational, observational cohort study. Lancet Child Adolesc Health 1:184–194 - DOI

MeSH terms

LinkOut - more resources