Peritoneal dialysis in children undergoing congenital cardiac surgery under three years of age

Background: This study aims to investigate the incidence, risk factors, and outcomes of peritoneal dialysis in children undergoing congenital cardiac surgery under three years of age. Methods: We included a total of 36 patients aged three years and below who underwent open heart surgery for congenital heart disease and peritoneal dialysis between December 2007 and April 2013. Demographic data, intraoperative variables, risk factors, and outcome data were retrospectively analyzed. Results: Recovery of renal functions was reported in 18 patients (50%) after peritoneal dialysis. Mortality was 72.2% (n=26). Eight of the patients with mortality were in the recovery group, while 18 patients were in the non-recovery group. The non-survivors (n=26, 72.3%) had a longer cardiopulmonary bypass time (101 +/- 30 vs 83 +/- 52 min, p=0.042), longer cross-clamp time (80.6 +/- 33.9 vs 56 +/- 34.7 min, p=0.033), postoperative longer time to initiate peritoneal dialysis (1.4 +/- 1.0 vs 0.6 +/- 2.0 days, p=0.048), higher mean inotrope score onset of peritoneal dialysis (34 +/- 9.8 vs 22 +/- 10.6, p<0.002), and higher Risk Adjustment for Congenital Heart Surgery-1 scores (2.9 +/- 0.8 vs 2.4 +/- 0.7, p<0.044) than the survivors (n=10, 27.7%). However, in the subgroup analysis, there was no statistically significant difference between recovery (n=18, % 50) and non-recovery (n=18, % 50) of the renal function groups. Conclusion: Peritoneal dialysis is a major complication associated with longer length of hospital stay and higher in-hospital mortality. Appropriate management of peritoneal dialysis, which is ideal for neonates, infants, and young children following congenital cardiac surgery may improve the prognosis.