Risk factors associated with acute kidney injury after corrective surgery for tetralogy of Fallot
- VernacularTitle:法洛四联症根治术后急性肾损伤的危险因素分析
- Author:
Tuo PAN
1
,
2
;
Xun WANG
2
,
3
Author Information
1. Fu Wai Hospital, Cardiovascular Institute, Chinese Academy of Medical Science &
2. Peking Union Medical College, Beijing, 100037, P.R.China
3. Department of Pediatric Intensive Care Unit, Fu Wai Hospital, Cardiovascular Institute, Chinese Academy of Medical Science &
- Publication Type:Journal Article
- Keywords:
Tetralogy of Fallot;
acute kidney injury;
pediatric intensive care;
cardiac surgery
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2017;24(7):495-500
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore risk factors related to acute kidney injury (AKI) in children who underwent corrective surgery for tetralogy of Fallot (TOF). Methods We retrospectively analyzed the clinical data of 726 children with corrective procedures for TOF aged less than 3 years in our hospital from March 1st 2010 to March 1st 2013. Children with AKI were picked using Acute Kidney Injury Network criteria. Demographic and perioperative variables of the remaining patients were reviewed. Univariate analysis was performed to compare the AKI group (240 patients) with the non-AKI group (486 patients). Multivariable analysis was carried out to identify significant determinants of AKI. Results A total of 240 children were with AKI. The result of univariate analysis showed that there was a statistical difference in age, Nakata index, McGoon ratio, left ventricular end-diastolic volume index (LVEDVI), transannular right ventricular outflow tract (RVOT) patch, or fresh frozen plasma (FFP) in prime solution between the AKI group and the non-AKI group. Multivariable logistic regression showed that in older children (OR=1.425, 95% CI 1.071 to 1.983, P=0.011) with more transfusion of FFP in the priming solution (OR=1.486, 95% CI 1.325 to 2.674, P<0.001) led to higher morbidity of mild AKI. In addition, there was an increase in morbidity related to AKI when children had less Nakata index (OR=0.282, 95% CI 0.092 to 0.869, P=0.013). Conclusion Postoperative AKI increases in older children group. Infusion of more FFP in priming solution increases morbidity of AKI. The less Nakata index is significantly associated with severe AKI.
