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Pediatric Nephrology

, Volume 21, Issue 10, pp 1446–1451 | Cite as

Renal function and cardiopulmonary bypass in pediatric cardiac surgical patients

  • Guillermo LemaEmail author
  • Andrea Vogel
  • Roberto Canessa
  • Roberto Jalil
  • Claudia Carvajal
  • Pedro Becker
  • Maria Paz Jaque
  • Christian Fajardo
  • Jorge Urzua
Original Article

Abstract

We studied prospectively the perioperative changes of renal function in nine children undergoing cardiac surgery with cardiopulmonary bypass (CPB). Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured with inulin and 131I-hippuran clearances before CPB, during hypo and normothermic CPB, following sternal closure and 1 h postoperatively. Urinary alpha glutathione S-transferase (alpha GS-T) was measured pre- and postoperatively as a marker for tubular cellular damage. Plasma and urine creatinine and electrolytes were measured. Free water, osmolal and creatinine clearances, as well as fractional excretion of sodium (FeNa) and potassium transtubular gradient (TTKG) were calculated. GFR was normal before and after surgery. ERPF was low before and after surgery; it increased significantly immediately after CPB. Filtration fraction (FF) was abnormally elevated before and after surgery; however, a significant decrease during normothermic CPB and sternal closure was found. Alpha GS-T presented a moderate, but nonsignificant increase postoperatively. FeNa also increased in this period, but not significantly. Creatinine, osmolal, free water clearances, as well as TTKG, were normal in all patients pre- and postoperatively. We conclude that there is no evidence of clinically significant deterioration of renal function in children undergoing repair of cardiac lesions under CPB. Minor increases of alpha GS-T in urine postoperatively did not confirm cellular tubular damage. There was no tubular dysfunction at that time.

Keywords

Cardiovascular anesthesia Cardiopulmonary bypass Renal function Cardiac surgery Pediatrics 

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Copyright information

© IPNA 2006

Authors and Affiliations

  • Guillermo Lema
    • 1
    Email author
  • Andrea Vogel
    • 2
  • Roberto Canessa
    • 1
  • Roberto Jalil
    • 3
  • Claudia Carvajal
    • 1
  • Pedro Becker
    • 4
  • Maria Paz Jaque
    • 1
  • Christian Fajardo
    • 1
  • Jorge Urzua
    • 5
  1. 1.Department of AnaesthesiologyPontificia Universidad Católica de ChileSantiagoChile
  2. 2.Department of PediatricsPontificia Universidad Católica de ChileSantiagoChile
  3. 3.Department of NephrologyPontificia Universidad Católica de ChileSantiagoChile
  4. 4.Department of Cardiovascular DiseasesPontificia Universidad Católica de ChileSantiagoChile
  5. 5.Santo Tomas UniversitySantiagoChile

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