Acute Renal Insufficiency and Renal Replacement Therapy After Pediatric Cardiopulmonary Bypass Surgery |
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Authors: | JE Kist-van Holthe tot Echten CA Goedvolk MBME Doornaar MMJ van der Vorst JM Bosman-Vermeeren R Brand AJ van der Heijden PH Schoof MG Hazekamp |
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Institution: | (1) Department of Pediatrics, Leiden University Medical Center, Postbus 9600, 2300 RC Leiden, The Netherlands, NL;(2) Department of Cardiothoracic Surgery, Leiden, University Medical Center and Academic Medical Center Amsterdam, The Netherlands, NL;(3) Department of Medical Statistics, Rijksuniversiteit, Leiden, The Netherlands, NL |
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Abstract: | The aim of the study was to investigate renal function and renal replacement therapy after cardiopulmonary bypass surgery
in children. Patient characteristics (sex, age, diagnosis), operation type, and death were listed. The study was performed
retrospectively using serum creatinine level before, and peak values after, cardiopulmonary bypass surgery for assessment
of renal function. Of the children on renal replacement therapy, indication, efficacy, and complications were recorded. In
a 5-year period, 1075 children had cardiopulmonary bypass surgery at the Department of Cardiothoracic Surgery at Leiden University
Medical Center and Academic Medical Center of Amsterdam. One-hundred eighty (17%) patients developed acute renal insufficiency.
Twenty-five (2.3%) patients required renal replacement therapy. Peritoneal dialysis is a safe and effective treatment for
children after cardiopulmonary bypass surgery. However, 15 (60%) of 25 children on renal replacement therapy died of nonrenal
causes. In 9 out of 10 surviving children, renal function was normal at time of discharge from hospital. Acute renal insufficiency
is a frequent complication after open-heart surgery, although renal replacement therapy was infrequently necessary. Peritoneal
dialysis is a safe and effective therapeutic measure for children after cardiac bypass surgery. |
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Keywords: | : Cardiopulmonary bypass surgery — Acute renal insufficiency — Acute renal failure — Child — Peritoneal dialysis — Pediatric cardiac surgery |
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