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Pediatric Nephrology

, Volume 28, Issue 7, pp 1127–1134 | Cite as

Epidemiology of cardiac surgery-associated acute kidney injury in neonates: a retrospective study

  • Abdullah AlAbbasEmail author
  • Andrew Campbell
  • Peter Skippen
  • Derek Human
  • Douglas Matsell
  • Cherry Mammen
Original Article

Abstract

Background

Cardiac surgery is a known risk factor for acute kidney injury (AKI) in children. However, cardiac surgery-associated AKI (CS-AKI) in neonates has not been well studied. The objectives of this study were: (1) to describe the epidemiology of CS-AKI in neonates utilizing the Acute Kidney Injury Network (AKIN) definition, (2) to identify risk factors for neonatal CS-AKI, and (3) to determine if neonatal CS-AKI is associated with increased morbidity and mortality.

Methods

This was a retrospective study involving 122 neonates (≤28 days) undergoing cardiac surgery from 2006 to 2009. Neonates with and without AKI were identified using serum creatinine (SCr) and urine output (UO) data.

Results

Cardiac surgery-AKI occurred in 76 (62 %) neonates, of whom 22 (29 %) were AKIN stage 1, 19 (25 %) were stage 2, and 35 (46 %) were stage 3. AKI mostly occurred early as 75 % of patients achieved their maximal AKIN stage within the first 48 h post-operatively. In the multivariate analysis, cardiopulmonary bypass duration of ≥120 min was independently associated with AKI [odds ratio (OR) 2.53, 95 % confidence interval (CI) 1.03–6.30]. Severe AKI (AKIN stage 3) was independently associated with mortality (OR 6.70, 95 % CI 1.08–41.50) and a longer stay in the pediatric intensive care unit (hazard ratio 9.09, 95 % CI 1.35–60.95). The majority of severe AKI cases (65 %) were identified with AKIN UO criteria alone without significant rises in SCr.

Conclusions

Cardiac surgery-AKI is common in neonates when the AKIN definition is utilized and is associated with higher morbidity and mortality, especially in those with more severe AKI.

Keywords

Acute kidney injury Neonatal Epidemiology Cardiac surgery Acute Kidney Injury Network 

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Copyright information

© IPNA 2013

Authors and Affiliations

  • Abdullah AlAbbas
    • 1
    Email author
  • Andrew Campbell
    • 2
  • Peter Skippen
    • 3
  • Derek Human
    • 4
  • Douglas Matsell
    • 1
  • Cherry Mammen
    • 1
  1. 1.Division of NephrologyBritish Columbia Children’s HospitalVancouverCanada
  2. 2.Division of Cardiothoracic SurgeryBritish Columbia Children’s HospitalVancouverCanada
  3. 3.Division of Critical CareBritish Columbia Children’s HospitalVancouverCanada
  4. 4.Division of CardiologyBritish Columbia Children’s HospitalVancouverCanada

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