Cardiac surgery-associated acute kidney injury (CSA-AKI) in adults and
pediatrics; prevention is the optimal management.
Abstract
Background Cardiac surgery-associated acute kidney injury
(CSA-AKI) is an important and serious complication that affects
morbidity and mortality. We studied both pediatric and adults using the
definition of the Acute Kidney Injury Network (AKIN). Methods
This is an observational retrospective cohort study done at King
Abdulaziz University Hospital in Jeddah, Saudi Arabia approved by
ethical committee. The exclusion criteria were baseline serum creatinine
(SCr) ≥ 4 mg/dL or preexisting renal failure requiring dialysis,
reoperation, death within 24 hours postoperatively, and operative
mortality or missing data. 941 patients were included in the analysis
using the statistical software SPSS, version 15.0.
Results 28.68% in the adult group and 20.07% in the pediatric
group developed CSA-AKI. Adult risk factors included age group of 60-69
years, cardiopulmonary bypass (CPB), number of grafts and hypertension.
In the pediatric group, CPB, aortic cross-clamping (ACX) and the lower
preoperative SCr are the main risk factors Conclusion
Conventional conservative management and preoperative Identification of
predictor risk factors are essential for prevention of CSA-AKI which
constitute the main strategy for optimal management.