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Acute kidney injury according to pediatric RIFLE criteria is associated with negative outcomes after heart surgery in children

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Abstract

Background

The aim of this study was to investigate the association between the occurrence of acute kidney injury (AKI) according to pediatric RIFLE (pRIFLE) criteria and adverse outcomes in children after heart surgery.

Methods

Children undergoing heart surgery in a tertiary hospital in Southern Brazil were followed during their stay in the pediatric intensive care unit (PICU) or until death. The exposure variable was occurrence of AKI according to pRIFLE criteria which place AKI in three categories: R (risk), I (injury), and F (failure). The outcomes studied were death, length of mechanical ventilation (MV), and length of PICU stay.

Results

Eighty-five children were enrolled in the study. Of these, 47 (55.3 %) did not have AKI, while 22 (25.9 %), seven (8.2 %), and nine (10.6 %) were classified into pRIFLE categories R, I, and F, respectively. The incidence of death was 18.4 and 4.2 % in patients with and without AKI, respectively. Compared to children who did not develop AKI, the adjusted odds ratio for death was 1.05 [95 % confidence interval (CI) 0.09–11.11], 8.36 (95 % CI 1.32–52.63), and 7.85 (95 % CI 1.53–40.29) in the R, I, and F groups, respectively (p = 0.022). Duration of MV and of PICU stay were significantly higher in those children with AKI.

Conclusions

The occurrence of AKI according to pRIFLE criteria is associated to adverse outcomes in children after heart surgery.

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Authors and Affiliations

  1. Faculdade de Medicina, Universidade Católica de Pelotas, Pelotas, RS, Brazil

    Michel Georges dos Santos El Halal

  2. Department of Pediatrics, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil

    Paulo Roberto A. Carvalho

  3. Hospital Universitário São Francisco de Paula, Universidade Católica de Pelotas, Rua Marechal Deodoro, 1123, Centro, CEP 96020-220, Pelotas, RS, Brazil

    Michel Georges dos Santos El Halal

Authors
  1. Michel Georges dos Santos El Halal
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  2. Paulo Roberto A. Carvalho
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Corresponding author

Correspondence to Michel Georges dos Santos El Halal.

Additional information

This work was performed at Hospital da Criança Santo Antônio, Porto Alegre, RS, Brazil.

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dos Santos El Halal, M.G., Carvalho, P.R.A. Acute kidney injury according to pediatric RIFLE criteria is associated with negative outcomes after heart surgery in children. Pediatr Nephrol 28, 1307–1314 (2013). https://doi.org/10.1007/s00467-013-2495-7

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  • DOI: https://doi.org/10.1007/s00467-013-2495-7

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