Acute kidney injury and fluid overload in infants and children after cardiac surgery

被引:33
作者
Kwiatkowski, David M. [1 ]
Krawczeski, Catherine D. [1 ]
机构
[1] Stanford Univ, Div Pediat Cardiol, Sch Med, 750 Welch Rd,Suite 321, Palo Alto, CA 94062 USA
关键词
Acute kidney injury; Fluid overload; Congenital heart disease; Congenital heart surgery; Peritoneal dialysis; ACUTE-RENAL-FAILURE; CONGENITAL HEART-SURGERY; SERUM CYSTATIN-C; PROPHYLACTIC PERITONEAL-DIALYSIS; CARDIOPULMONARY BYPASS; INITIAL-EXPERIENCE; PEDIATRIC-PATIENTS; RISK-FACTORS; BIOMARKERS; CREATININE;
D O I
10.1007/s00467-017-3643-2
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Acute kidney injury is a common and serious complication after congenital heart surgery, particularly among infants. This comorbidity has been independently associated with adverse outcomes including an increase in mortality. Postoperative acute kidney injury has a complex pathophysiology with many risk factors, and therefore no single medication or therapy has been demonstrated to be effective for treatment or prevention. However, it has been established that the associated fluid overload is one of the major determinants of morbidity, particularly in infants after cardiac surgery. Therefore, in the absence of an intervention to prevent acute kidney injury, much of the effort to improve outcomes has focused on treating and preventing fluid overload. Early renal replacement therapy, often in the form of peritoneal dialysis, has been shown to be safe and beneficial in infants with oliguria after heart surgery. As understanding of the pathophysiology of acute kidney injury and the ability to confidently diagnose it earlier continues to evolve, it is likely that novel preventative and therapeutic interventions will be available in the future.
引用
收藏
页码:1509 / 1517
页数:9
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