103 IMPACT OF UNDER-RECOGNIZED ACUTE KIDNEY INJURY POST CARDIAC SURGERY

AbstractAcute kidney injury (AKI) following cardiac surgery significantly increases morbidity and mortality risks. Improving existing clinical methods of identifying patients at risk of perioperative AKI may advance management and treatment options. This study investigated whether a combination of biomarkers and clinical factors pre and post cardiac surgery could stratify patients at risk of developing AKI. Patients (n = 401) consecutively scheduled for elective cardiac surgery were prospectively studied. Clinical data was recorded and blood samples were tested for 31 biomarkers. Areas under receiver operating characteristic (AUROCs) were generated for biomarkers pre and postoperatively to stratify patients at risk of AKI. Preoperatively sTNFR1 had the highest predictive ability to identify risk of developing AKI postoperatively (AUROC 0.748). Postoperatively a combination of H-FABP, midkine and sTNFR2 had the highest predictive ability to identify AKI risk (AUROC 0.836). Preoperative clinical risk factors included patient age, body mass index and diabetes. Perioperative factors included cardio pulmonary bypass, cross-clamp and operation times, intra-aortic balloon pump, blood products and resternotomy. Combining biomarker risk score (BRS) with clinical risk score (CRS) enabled pre and postoperative assignment of patients to AKI risk categories. Combining BRS with CRS will allow better management of cardiac patients at risk of developing AKI.

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MON-246 LONG TERM RENAL OUTCOMES IN CHILDREN WITH ACUTE KIDNEY INJURY POST CARDIAC SURGERY [ROCKS TRIAL]- RESULTS OF ISN CLINICAL RESEARCH PROGRAM GRANT

Kidney International Reports ◽

10.1016/j.ekir.2019.05.1048 ◽

2019 ◽

Vol 4 (7) ◽

pp. S400-S401

Author(s):

S. Sethi ◽

R. Sharma ◽

M.J. Mhanna ◽

A. Gupta ◽

A. Bhan ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Clinical Research ◽

Research Program ◽

Kidney Injury ◽

Renal Outcomes ◽

Program Grant ◽

Post Cardiac Surgery

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735 Acute kidney injury in neonates following post cardiac surgery utilizing the akin definition: A retrospective study

Canadian Journal of Cardiology ◽

10.1016/j.cjca.2011.07.608 ◽

2011 ◽

Vol 27 (5) ◽

pp. S332-S333

Author(s):

A.E. Alabbas ◽

R. Milner ◽

P. Skippen ◽

D.G. Human ◽

A. Campbell ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Retrospective Study ◽

Kidney Injury ◽

Post Cardiac Surgery

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Post Cardiac Surgery Acute kidney Injury: A Woebegone Status Rejuvenated by the Novel Biomarkers

Nephro-Urology Monthly ◽

10.5812/numonthly.19598 ◽

2014 ◽

Vol 6 (4) ◽

Cited By ~ 8

Author(s):

Rajesh Jayaraman ◽

Sham Sunder ◽

Satyanand Sathi ◽

Vijay Kumar Gupta ◽

Neera Sharma ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Kidney Injury ◽

The Novel ◽

Novel Biomarkers ◽

Post Cardiac Surgery

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Acute Kidney Injury Post-cardiac Surgery in Infants and Children: A Single-Center Experience in a Developing Country

Frontiers in Pediatrics ◽

10.3389/fped.2021.637463 ◽

2021 ◽

Vol 9 ◽

Author(s):

Bilal Aoun ◽

Ghadi Abu Daher ◽

Karim N. Daou ◽

Sami Sanjad ◽

Hani Tamim ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Heart Disease ◽

Developing Country ◽

Kidney Injury ◽

Infants And Children ◽

Cyanotic Heart Disease ◽

Incidence And Mortality ◽

Post Cardiac Surgery ◽

In Infants And Children

Introduction: The incidence of acute kidney injury (AKI) in pediatric patients following cardiac surgery varies between 15 and 64%, with a mortality rate of 10–89% among those requiring dialysis. This variation in the incidence and mortality of AKI across studies is probably due to the inconsistent definitions used for AKI. The purpose of this study is to present our experience with AKI post-cardiac surgery with emphasis on predisposing or aggravating factors.Patients and Methods: We evaluated the incidence of AKI using the KDIGO criteria in 150 infants and children undergoing cardiac surgeries between 2015 and 2017. Post-operatively, all patients were admitted to the pediatric intensive care unit (PICU) at a tertiary care center in a developing country. This is a retrospective chart review in which data collected included age, gender, type of heart disease, prior cardiac surgeries, RACHS-1 category, and pre- and post-operative creatinine levels. Neonates were not included in this study.Results: Six percent of the studied patients were below 1 year of age, 84% 1–10 years, and 10% 10–18 years. Fourteen patients (9.3%) developed AKI. Patients with cyanotic heart disease were more prone to develop AKI (78%) compared to those with non-cyanotic heart disease (44%). Children with AKI had a higher length of stay in PICU, 2.56 ± 1.44 vs. 4 ± 2.66 (p- 0.02). Serum lactic acid was higher in patients who developed AKI with a mean value of 6.8 ± 6.9 vs. 2.85 ± 1.55 mmol/l in the non-AKI group (p- 0.03). Lower hemoglobin levels and hyperlactic acidemia were significantly more prevalent in the AKI group. There were five deaths in this series (3.3%), and four of those (80%) were in the AKI group.Conclusion: Using the KDIGO criteria, the incidence of AKI in infants and children following cardiac surgery was 9.3%. This is slightly lower than in previously published studies where the range was between 15 and 64%. Children with cyanotic cardiac disease, hyperlactic acidemia, and anemia were more prone to developing AKI. Identifying patients at risk might help decrease the risk of post-operative AKI.

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