Risk Factors and Primary Diseases Responsible for Acute Kidney Injury among Neonates

2021 ◽  
Vol 8 (1) ◽  
pp. 12-16
Author(s):  
Sharmin Akter Luna ◽  
Syma Akter ◽  
Tahmina Jesmin ◽  
Syed Saimul Haque ◽  
Golam Muin Uddin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Age Group ◽  
Cross Sectional ◽  
One Year

Background: There are several risk factors and diseases related with the acute kidney injury among neonates. Objective: The purpose of the present study was to find out the risk factors and primary disease responsible for acute kidney injury among neonates. Methodology: This cross-sectional study was conducted in the Department of Paediatric Nephrology at Bangabandhu Sheikh Mujib University, Dhaka, Bangladesh from May 2018 to July 2019 for a period of one year. Patients with the age group of less than 1 months who were at risk of AKI, and admitted in the inpatient department of Pediatrics and allied at Bangabandhu Sheikh Mujib University, Dhaka, Bangladesh in both sexes were selected as study population. To detect AKI, serum creatinine was measured at 0 h (baseline), 48 h and 5th day respectively. Result: A total number of 52 patients who fulfilled the inclusion criteria were enrolled in this study. Among them 10 cases were in neonatal age group. The mean age was 10.8±5.4 days with female predominance. The risk factors of AKI in neonate was only pre-renal; mostly due to hypovolemia which was 3(60.0%) cases followed by sepsis and asphyxia which were 1(20.0%) case in each. The most patients had sepsis which was 4(40.0%) cases followed by congenital heart disease which was 2(20.0%) cases; one presented with heart failure and another one had cyanotic congenital heart disease. Conclusion: In conclusion hypovolemia, sepsis and asphyxia are the most common risk factors of acute kidney injury among the neonates. Journal of Current and Advance Medical Research, January 2021;8(1):12-16

scholarly journals Common Risk Factors Responsible for Acute Kidney Injury among Children: Experience at Medical University in Bangladesh

2021 ◽  
Vol 7 (1) ◽  
pp. 42-46
Author(s):  
Sharmin Akter Luna ◽  
Jakia Sultana ◽  
Abdullah Al Mamun ◽  
Afroza Begum ◽  
Md Habibur Rahman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Radiocontrast Agent ◽  
Nephrotoxic Drugs ◽  
Common Risk Factors ◽  
One Year ◽  
Medical University

Background: Acute kidney injury can occur among the younger children due to different reasons. Objective: The purpose of the present study was to find out the risk factors and primary disease responsible for acute kidney injury among younger children. Methodology: This cross-sectional study was conducted in the Department of Paediatric Nephrology with the collaboration of Paediatric Gastroenterology, Paediatric Neurology, Paediatric Neonatology and Microbiology and Immunology at Bangabandhu Sheikh Mujib University, Dhaka, Bangladesh from May 2018 to July 2019 for a period of one year. Patients with the age group of 1 month to 17 years who were at risk of AKI, and admitted in the inpatient department of Pediatrics and allied at Bangabandhu Sheikh Mujib University, Dhaka, Bangladesh in both sexes were selected as study population. To detect AKI, serum creatinine was measured at 0 h (baseline), 48 h and 5th day respectively. Result: A total number of 42 patients, who fulfilled the inclusion criteria were enrolled in this study. The risk factors of AKI was mainly pre renal in 60% (n=9) cases, mostly due to nephrotoxic drugs followed by hypovolemia. Renal causes were in 40% (n=6) cases. Among these 50% cases due to amikacin and 50% cases due to use of radiocontrast agent. Most patients were with renal disease which was 30(58%) cases. Among them 28(93.0%) cases were nephrotic syndrome and 2(7.0%) cases were hydronephrosis. However, 7(13%) cases were cardiac disease presented with congenital heart disease who used radiocontrast agent. Conclusion: In conclusion most common risk factors of acute kidney injury among younger children is pre-renal causes which are due to nephrotoxic drugs. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 42-46

Incidence, risk factors, and outcomes of acute kidney injury in adults undergoing surgery for congenital heart disease

2016 ◽  
Vol 27 (6) ◽  
pp. 1068-1075 ◽  
Author(s):  
David M. Kwiatkowski ◽  
Elizabeth Price ◽  
David M. Axelrod ◽  
Anitra W. Romfh ◽  
Brian S. Han ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Kidney Injury ◽  
Congenital Heart Surgery ◽  
Left Ventricular

AbstractBackgroundAcute kidney injury after cardiac surgery is a frequent and serious complication among children with congenital heart disease (CHD) and adults with acquired heart disease; however, the significance of kidney injury in adults after congenital heart surgery is unknown. The primary objective of this study was to determine the incidence of acute kidney injury after surgery for adult CHD. Secondary objectives included determination of risk factors and associations with clinical outcomes.MethodsThis single-centre, retrospective cohort study was performed in a quaternary cardiovascular ICU in a paediatric hospital including all consecutive patients ⩾18 years between 2010 and 2013.ResultsData from 118 patients with a median age of 29 years undergoing cardiac surgery were analysed. Using Kidney Disease: Improving Global Outcome creatinine criteria, 36% of patients developed kidney injury, with 5% being moderate to severe (stage 2/3). Among higher-complexity surgeries, incidence was 59%. Age ⩾35 years, preoperative left ventricular dysfunction, preoperative arrhythmia, longer bypass time, higher Risk Adjustment for Congenital Heart Surgery-1 category, and perioperative vancomycin use were significant risk factors for kidney injury development. In multivariable analysis, age ⩾35 years and vancomycin use were significant predictors. Those with kidney injury were more likely to have prolonged duration of mechanical ventilation and cardiovascular ICU stay in the univariable regression analysis.ConclusionsWe demonstrated that acute kidney injury is a frequent complication in adults after surgery for CHD and is associated with poor outcomes. Risk factors for development were identified but largely not modifiable. Further investigation within this cohort is necessary to better understand the problem of kidney injury.

scholarly journals Trends in the Prevalence of Atrial Septal Defect and Its Associated Factors among Congenital Heart Disease Patients in Vietnam

2019 ◽  
Vol 7 (1) ◽  
pp. 2
Author(s):  
Ho Xuan Tuan ◽  
Phan The Phuoc Long ◽  
Vu Duy Kien ◽  
Le Manh Cuong ◽  
Nguyen Van Son ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Atrial Septal Defect ◽  
Associated Factors ◽  
Health Care Services ◽  
Congenital Heart ◽  
Septal Defect ◽  
Cross Sectional Study ◽  
Age Group ◽  
Cross Sectional

Atrial septal defect (ASD) is a non-physiologic communication between the two atria, allowing the shunt between systemic and pulmonary circulation. Data about ASD prevalence among congenital heart disease patients (CHD) in Vietnam are still scarce. We aim to assess the trends in the prevalence of ASD patients and associated factors among CHD patients. This was a cross-sectional study, with data collected from medical records from 1220 CHD patients in Da Nang hospital from 1 January 2010 to 31 December 2015. Descriptive statistics were used to estimate the prevalence of ASD among CHD patients. Comparative statistical methods were used to compare groups and logistic regression to access associated factors with ASD. The overall prevalence of ASD among CHD patients was 18.5% between 2010 and 2015. The prevalence varied between periods, ranging between 15% and 31.9% during the period. The prevalence of ASD women among CHD (25.9%) was significantly higher than for men (16.0%). The prevalence of ASD increased gradually when the age group increased. The factors associated with increased ASD prevalence were being a female and being in an older age group. The findings suggest that targeted policy should provide more-specific health-care services of ASD for women and older patients.

Independent Risk Factors and 2-Year Outcomes of Acute Kidney Injury after Surgery for Congenital Heart Disease

2017 ◽  
Vol 46 (3) ◽  
pp. 204-209 ◽  
Author(s):  
Daishi Hirano ◽  
Akira Ito ◽  
Akifumi Yamada ◽  
Daisuke Kakegawa ◽  
Saori Miwa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Congenital Heart Disease ◽  
Cardiac Surgery ◽  
Heart Disease ◽  
Congenital Heart ◽  
Temporal Trends ◽  
Kidney Injury ◽  
Young Age ◽  
Independent Risk Factors

Background: Data are limited regarding risk factors for acute kidney injury (AKI) following cardiac surgery in children with congenital heart disease (CHD). This observational study was performed to examine temporal trends in AKI incidence according to the Pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease (pRIFLE) criteria, identify independent risk factors for AKI after cardiac surgery, and examine associations between AKI and long-term mortality. Methods: We retrospectively evaluated 418 patients (259 males, 159 females; median age, 5 months) who underwent cardiac surgery for CHD between April 2007 and August 2013. Patients were followed up for 2 years. AKI was defined according to the pRIFLE criteria as ≥25% decrease in estimated creatinine clearance. Results: AKI developed postoperatively in 104 cases (24.9%). Approximately 80% belonged to the “Risk” category according to the pRIFLE criteria, and only 21 cases (5%) required renal replacement therapy (peritoneal dialysis in all cases). Multivariate analysis revealed 3 independent risk factors for onset of AKI: young age (<1 year), surgery in Risk Adjustment in Congenital Heart Surgery (RACHS-1) category ≥4, and long cardiopulmonary bypass (CPB) time (≥90 min). Twenty-three patients (22%) with AKI died during the 2-year follow-up. In multivariate cox hazard regression analysis, the most significant contributor to risk of mortality was AKI. Conclusions: Postoperative AKI was strongly associated with young age, high RACHS-1 category, and prolonged CPB time. In addition, mortality rate was higher in patients who survived after recovery from AKI than in those without AKI, even among the lower pRIFLE categories.

scholarly journals Characteristics of Children Hospitalized with Infective Endocarditis at Dhaka Shishu Hospital

2019 ◽  
Vol 12 (1) ◽  
pp. 33-39
Author(s):  
Rezoana Rima ◽  
Mohammad Abdullah Al Mamun
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Infective Endocarditis ◽  
Congenital Heart ◽  
Cardiac Involvement ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Pediatric Age Group ◽  
High Index Of Suspicion

Background: The characteristics of infective endocarditis (IE) have significantly changed in pediatric age group during last few decades. The present study was conducted to study the clinical & lab profile, risk factors, site of cardiac involvement and outcome of infective endocarditis in the largest children hospital of Bangladesh. Methods: This prospective cross-sectional study was conducted in cardiology department with a diagnosis of IE from February 2014 to August 2016. Twenty- four children fulfilled the modified Duke diagnostic criteria. Results: Definite IE was found in 58% (14/24) patients, while the rest had possible IE. The most common presenting symptom was prolonged fever (> 2 weeks) & heart murmur. Most commonly encountered risk factors included congenital heart disease (54%), most commonly ventricular septal defect (21%). Two patients (8.3%) had history of rheumatic heart disease. Other important risk factors include post cardiac surgery (16.7%), prolonged ICU stay of neonates (20.8%). Nineteen patients (79%) were classified as having culture-negative endocarditis and five (21%) as culture positive. The most frequently isolated organisms were streptococci and followed by staphylococci and candida. Fifteen (62.5%) patients had right-sided cardiac involvement. Seven (29%) patients died of endocarditis or its complications. Conclusion: Clinicians should have a high index of suspicion of endocarditis in persistently febrile patients with congenital heart disease and send blood cultures or refer appropriately before prescribing antibiotics. Cardiovasc. j. 2019; 12(1): 33-39

Preoperative Albumin Level is not Associated with Acute Kidney Injury After Pediatric Cardiac Surgery: A Retrospective Cohort

2021 ◽  
Author(s):  
Fatma Ukil Isildak ◽  
Yasemin Yavuz ◽  
Omer Faruk Savluk ◽  
Nihat Cine ◽  
Ufuk Uslu
Keyword(s):  
Acute Kidney Injury ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Retrospective Cohort ◽  
Congenital Heart ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Kidney Injury ◽  
Open Heart ◽  
Preoperative Albumin

Objectives: This study aimed to evaluate whether the development of acute kidney injury (AKI) was associated with preoperative albumin/prealbumin levels and other clinical features in pediatric patients who underwent open-heart surgery for congenital heart disease. Patients and Methods: In this retrospective cohort, patients aged between 1 – 60 months who underwent open-heart surgery (complete correction surgery) with a diagnosis of congenital heart disease at the XXXXXX, between January 1, 2018 - December 31, 2020, were retrospectively included (n = 100). Patient demographics, diagnoses, surgical characteristics, and laboratory findings were recorded and analyzed. Results: Mean age was 13.63 ± 12.05 (range 1.5 - 60) months. eGFR was decreased by more than 50% in 13% of the cases. Compared to the preoperative period, it was found that urea (24th and 48th hour) and creatinine levels increased significantly (p< 0.001, for each), and eGFR decreased significantly in the postoperative period (p< 0.001). Linear regression for eGFR value revealed that longer aortic cross-clamp time (ACCT) was associated with a greater decrease in eGFR (p= 0.046). Other variables included in the model, age (p= 0.128), gender (p= 0.358), RACHS (p= 0.865), body mass index (p= 0.862), prealbumin (p= 0.313), albumin (p= 0.806) and duration of cardiopulmonary bypass (p= 0.921) were found to be non-significant. Conclusion: While there was no relationship between eGFR and preoperative albumin/prealbumin levels in patients who underwent cardiac surgery due to congenital heart disease, longer ACCT was found to be associated with decreased eGFR.

Chronic Kidney Disease in Adolescents after Surgery for Congenital Heart Disease

2020 ◽  
Vol 10 (5) ◽  
pp. 353-361
Author(s):  
Mirela Bojan ◽  
Laurence Pieroni ◽  
Cristian Mirabile ◽  
Marc Froissart ◽  
Damien Bonnet
Keyword(s):  
Chronic Kidney Disease ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Kidney Disease ◽  
Cystatin C ◽  
Congenital Heart ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Orthostatic Proteinuria ◽  
Age Range

Background: The onset of chronic kidney disease (CKD) is an important prognostic factor in young adults with congenital heart disease (CHD). Although it is likely that CKD is manifest early in CHD patients, the prevalence among adolescents is still unknown. The National Kidney Foundation’s Kidney Disease Improving Global Outcomes guidelines 2012 recommend new equations for the estimated glomerular filtration rate (eGFR) and highlight the importance of albuminuria for CKD screening. The objective of the present study was to estimate the prevalence of CKD in CHD adolescents. Methods: This observational cross-sectional study included 115 patients aged 10–18 years attending the cardiologic outpatient clinic at our institution as a follow-up after cardiac surgery in infancy related to various CHDs. CKD assessment used the CKD criteria 2012, including eGFR equations based on serum creatinine and cystatin C, and measurement of albuminuria. Results: No patient had an eGFR <60 mL min–1 1.73 m–2. However, 28.7% of all patients (95% CI 20.7–37.9) had eGFRbetween 60 and 89 mL min–1 1.73 m–2 when estimated by the bedside Schwartz creatinine-based equation,and 17.4% (95% CI 11.2–24.1) had eGFRbetween 60 and 89 mL min–1 1.73 m–2 when estimated by the Zappitelli equation, combining creatinine and cystatin C. Of all patients, 20.0% (95% CI 12.1–26.7) had orthostatic proteinuria, and none had persistent albuminuria. Conclusions: There was no evidence of CKD in the present population aged 10–18 years. The significance of an eGFR between 60 and 90 mL min–1 1.73 m–2 is not concordant for this age range and requires further investigations.

scholarly journals Prevalence of Congenital Heart Disease: A Single Center Experience in Southwestern of Iran

2016 ◽  
Vol 8 (10) ◽  
pp. 288 ◽  
Author(s):  
Pedram Nazari ◽  
Mohammad Davoodi ◽  
Mohammad Faramarzi ◽  
Mohammad Bahadoram ◽  
Nozar Dorestan
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Family History ◽  
Congenital Heart ◽  
Septal Defect ◽  
Cross Sectional Study ◽  
Concomitant Disease ◽  
Single Center ◽  
Cross Sectional ◽  
Single Center Experience

<p><strong>BACKGROUND:</strong> Congenital heart disease (CHD) refers to complex abnormalities that affect the structure or function of the heart due to embryonic defects. There is little accurate statistical data about prevalence, incidence and frequency in many developing countries such as Iran. The aim of this study was to evaluate the frequency of CHD in patients who were referred to the Department of Pediatric Cardiology in a large single-center in Southwestern of Iran.</p><p><strong>METHODS:</strong> This is a retrospective, cross-sectional study. Patients with various cardiac malformations were each investigated separately. A check list was used to collect information. It was comprised of three parts; demographic characteristics, Patient’s birth details and maternal data.</p><p><strong>RESULTS:</strong> The frequency of ventricular septal defect (VSD), atrial septal defect (ASD) and tetralogy of fallot (TOF) were 125 (28.47%), 48 (10.93%) and 41(9.3%) respectively. Family history was reported in 26(11.1%) cases. Down syndrome, skeletal anomaly and hematological anomaly were the most common co-anomalies. Parental consanguinity was 48.7%.</p><p><strong>CONCLUSIONS:</strong> Present study showed that VSD was the most common CHD subtype followed by family history, familial marriage, extra cardiac anomalies (ECAs), birth weight, and maternal concomitant disease. But there was a controversial relationship between birth order and drug history in CHD.</p>

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