Mild acute kidney injury after pediatric surgery is not-associated with long-term renal dysfunction: A retrospective cohort study

被引:2
作者
Onal, Ozkan [1 ,2 ,8 ]
Chhabada, Surendrasingh [1 ,3 ,8 ]
Pu, Xuan [1 ,4 ,8 ]
Liu, Liu [1 ,4 ,8 ]
Shimada, Tetsuya [1 ,5 ,6 ,8 ]
Ruetzler, Kurt [1 ,7 ,8 ]
Turan, Alparslan [1 ,7 ,8 ,9 ]
机构
[1] Anesthesiol Inst, Dept Outcomes Res, Cleveland Clin, Cleveland Hts, OH USA
[2] Selcuk Univ Fac Med, Dept Anesthesiol & Reanimat, Konya, Turkey
[3] Cleveland Clin, Dept Pediat Anesthesia & Congenital Cardiac Anesth, Cleveland Hts, OH USA
[4] Dept Quantitat Hlth Sci, Cleveland Clin, Cleveland, OH USA
[5] Murayama Med Ctr, Natl Hosp Org, Dept Anesthesiol, Tokyo, Japan
[6] Natl Def Med Coll, Dept Anesthesiol, Tokorozawa, Saitama, Japan
[7] Dept Gen Anesthesia, Cleveland Clin, Cleveland Hts, OH USA
[8] Outcomes Res Consortium, Cleveland Hts, OH USA
[9] 9500 Euclid Ave, P-77, Cleveland Hts, OH 44195 USA
关键词
Renal function; Acute kidney injury; Chronic kidney disease; Pediatric; NONCARDIAC SURGERY; CARDIAC-SURGERY; FOLLOW-UP; OUTCOMES; EPIDEMIOLOGY; CHILDREN;
D O I
10.1016/j.jclinane.2022.110985
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background and study objective: Acute kidney injury (AKI) is a sudden deterioration in renal function and is common in pediatric patients undergoing cardiac and non-cardiac surgery. Few studies have investigated the association of postoperative AKI with kidney dysfunction seen long-term and other adverse outcomes in pediatric patients. The study aimed to determine the association between postoperative AKI (mild AKI vs. no AKI and mild AKI vs. moderate-severe AKI) and chronic kidney dysfunction (CKD) seen long-term in pediatric patients un-dergoing cardiac and non-cardiac major surgery.Design: Restrospective, cohort study.Setting: Tertiary care hospital.Patients: This retrospective cohort study included patients aged 2-18 years who underwent cardiac and non -cardiac major surgery lasting > 2 h at the Cleveland Clinic Main Campus between June 2005 and December 2020.Measurements: Postoperative AKI and CKD seen in long-term were defined and staged according to the Kidney Disease: Improving Global Outcomes criteria.Main results: Among 10,597 children who had cardiac and non-cardiac major surgery, 1,302 were eligible. A total of 682 patients were excluded for missing variables and baseline kidney dysfunction and 620 patients were included. The mean age was 11 years, and 307 (49.5%) were female. Postoperative mild AKI was detected in 5.8% of the patients, while moderate-severe AKI was detected in 2.4%. There was no significant difference in CKD seen in long-term between patients with and without postoperative AKI, p = 0.83. The CKD seen in long-term developed in 27.7% of patients with postoperative mild AKI and 33.3% of patients with postoperative moderate and severe AKI. Patients without postoperative AKI had an estimated 1.09 times higher odds of having CKD seen in long-term compared with patients who have postoperative mild AKI (odds ratio [95% CI] 1.09 [0.48,2.52]).Conclusion: In contrast to adult patients, the authors did not find any association between postoperative AKI and CKD seen in long-term in pediatric patients.
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页数:6
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