ACUTE KIDNEY INJURY IN NEONATES AND INFANTS WITH CONGENITAL HEART DISORDERS AFTER CARDIAC SURGERY
https://doi.org/10.24884/1561-6274-2017-3-54-60
Abstract
THE AIM. To determine frequency and severity of cardiac surgery-associated acute kidney injury (CSA-AKI) according to the predictive RACHS system of 6 risk categories in newborns and infants with CHD.
PATIENTS AND METHODS. The study included 65 children under 1 year with CHD, 29 of them (44.62%) neonates and 36 newborns (55.38%) from 1 month to 1 year underwent surgery. The diagnosis of AKI was set up according to AKIN criteria (2007), with allocating 3 stages using the serum creatinine level (SCr). The severity of cardiac surgery associated AKI was distributed by categories of RACHS system of 6 risk categories in newborns and infants with CHD.
RESULTS. 72,1% of neonates and 41,67% of infants developed cardiac surgeryassociated AKI. Statistically significant differences in the incidence of AKI in newborns operated on with or without cardiopulmonary bypass were not revealed. In infants from 1 month to 1 year there were differences in AKI frequency with regard to using bypass for surgical correction (p<0,001). Depending on the RACHS risk category, AKI developed in 2nd category – 25%, 3rd category in 28.57%, 4th – 78,95% and 6th – 91.67%, respectively. In the 3rd risk category CSA-AKI was increased in neonates (45.45%) comparing to infants (10%) (p=0.049). Statistically significant differences in the development of AKI in neonates and infants in categories 4 and 6 RACHS were not found (p>0,05). The high incidence of AKI in 4-6 categories established both in neonates and infants.
CONCLUSION. The high incidence of CSA-AKI in neonates and infants requires a multidisciplinary approach for diagnosis and treatment in the cardiac ICU. The distribution of patients by RACHS categories allows to predict the risk and severity of CSA-AKI in newborns and infants.
About the Authors
A. A. Seliverstova
Saint-Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
MD, Cardiologist of the Department of Anesthesiology and Intensive Care of children with cardiac surgical pathology clinic;
Postgraduate, the Department of faculty Pediatric,
194100, St-Petersburg, Litovskaya str., 2
N. D. Savenkova
Saint-Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
Prof., MD, PhD, DMedSci, Head of the Department of faculty pediatrics,
194100, St-Petersburg, Litovskaya str.,2
G. G. Hubulava
Saint-Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
Academician of RAS, MD, PhD, DMedSci, Head of the Department of Cardiovascular Surgery,
194100, St-Petersburg, Litovskaya str., 2
S. P. Marchenko
Saint-Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
Prof., MD PhD, DMedSci, Department of Cardiovascular Surgery
194100, St-Petersburg, Litovskaya str.,2
A. B. Naumov
Saint-Petersburg State Pediatric Medical University
Russian Federation
Russian Federation
MD, Chief of the Department of Anesthesiology and Intensive Care of children with cardiac surgical pathology clinic,
194100, St-Petersburg, Litovskaya str., 2
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Review
For citations:
Seliverstova A.A., Savenkova N.D., Hubulava G.G., Marchenko S.P., Naumov A.B. ACUTE KIDNEY INJURY IN NEONATES AND INFANTS WITH CONGENITAL HEART DISORDERS AFTER CARDIAC SURGERY. Nephrology (Saint-Petersburg). 2017;21(3):54-60. (In Russ.) https://doi.org/10.24884/1561-6274-2017-3-54-60
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