KASMEJ

Kastamonu Medical Journal regularly publishes internationally qualified issues in the field of Medicine in the light of up-to-date information.

EndNote Style
Index
Original Article
Evaluation of the incidence and risk factors of acute renal injury according to the prifle criteria in children with ventricular septal defect (VSD) and atrioventricular septal defect (AVSD) after cardiovascular interference
Aims: We aimed to determine the incidence and risk factors of acute kidney injury (AKI) according to pRIFLE (Risk, Injury, Failure, Loss, Endstage) criteria and to evaluate its effect on prognosis in patients followed up in intensive care unit after interventions for heart disease.
Methods: The study included 84 patients who underwent surgery for VSD and AVSD between January 2016 and September 2016 in the Pediatric Cardiovascular Surgery Clinic of Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital. Patients were prospectively analyzed. Primary disease, demographic data, duration of intensive care and hospital stay, duration of follow-up on ventilator, urine output, vital signs, intraoperative data, primary and secondary problems, and renal function tests were recorded.
Results: Among the patients, 35 were male, 49 were female, 30 were diagnosed with AVSD and 54 with VSD. pRIFLE classification revealed AKI in 19 patients. When the AKI (+) and non-AKI (+) groups were compared, no significant difference was found between the duration of cardiopulmonary bypass (CPB) in the AKI(+) group, while hypothermia levels were significantly lower (p=0.003). Mortality and length of hospital stay were significantly higher in the AKI(+) group.
Conclusion: AKI is a serious complication in pediatric cardiac surgery patients. The presence and extent of damage is closely related to morbidity and mortality. The use of an inexpensive, easily applicable method such as pRIFLE criteria is recommended for the detection and grading of AKI.


1. Hassinger AB, Wald EL, Goodman DM. Early postoperative fluid overload precedes acute kidney injury and is associated with higher morbidity in pediatric cardiac surgery patients. Pediatr Crit Care Med. 2014;15(2):131-138. doi:10.1097/PCC.0000000000000043
2. Okusa MD. The inflammatory cascade in acute ischemic renal failure. Nephron. 2002;90(2):133-138. doi:10.1159/000049032
3. Salis S, Mazzanti VV, Merli G, et al. Cardiopulmonary bypass duration is an independent predictor of morbidity and mortality after cardiac surgery. J Cardiothorac Vasc Anesth. 2008;22(6):814-822. doi:10.1053/j.jvca.2008.08.004
4. Li S, Krawczeski CD, Zappitelli M, et al. TRIBE-AKI Consortium: incidence, risk factors, and outcomes of acute kidney injury after pediatric cardiac surgery: a prospective multicenter study. Crit Care Med. 2011;39(6):1493-1499. doi:10.1097/CCM.0b013e31821201d3
5. Sethi SK, Goyal D, Yadav DK, et al. Predictors of acute kidney injury post-cardiyopulmonary bypass in children. Clin Exp Nephrol 2011;15(4): 529-534. doi:10.1007/s10157-011-0440-2
6. Dittrich S, Kurschat K, Dähnert I, et al. Renal function after cardiopulmonary bypass surgery in cyanotic congenital heart disease. Int J Cardiol., 2000;73(2):173-179. doi:10.1016/s0167-5273(00)00217-5
7. Aydin SI, Seiden HS, Blaufox AD, et al. Acute kidney injury after surgery for congenital heart disease. Ann Thorac Surg. 2012;94(5):1589-1595. doi:10.1016/j.athoracsur.2012.06.050
8. Toth R, Breuer T, Cserep Z, et al. Acute kidney injury is associated with higher morbidity and resource utilization in pediatric patients undergoing heart surgery. Ann Thorac Surg. 2012;93(6):1984-1990. doi: 10.1016/j.athoracsur.2011.10.046
9. Zappitelli M, Bernier PL, Saczkowski RS, et al. A small postoperative rise in serum creatinine predicts acute kidney injury in children undergoing cardiac surgery. Kidney Int. 2009;76(8):885-892. doi:10.1038/ki.2009.270
10. Kallel S, Triki Z, Abdenadher M, Frikha I, Jemel A, Karoui A. Acute renal failure after cardiac surgery: evaluation of the RIFLE criteria. Nephrol Ther. 2013;9(2):108-114. doi:10.1016/j.nephro.2012.06.006
11. Ricci Z, Ronco C. Neonatal RIFLE. Nephrol Dial Transplant. 2013;28(9): 2211-2214. doi:10.1093/ndt/gft074
12. Georgiev S, Konstantinov G, Latcheva A, Mitev P, Mitev I, Lazarov S. Phrenic nerve injury after paediatric heart surgery: is aggressive plication of the diaphragm beneficial? Eur J Cardiothorac Surg. 2013; 44(5):808-812. doi:10.1093/ejcts/ezt110
13. Encalada JF, Campelos P, Delgado C. Surgery in the cardiovascular surgical intensive care unit. Cir Esp. 2016;94(4):227-231. doi:10.1016/j.ciresp.2015.07.004
14. Das MM. Modern pacemakers: present and future. BoD-Books on Demand. 2011.
15. Zaccaria S. Hemoglobin and renal replacement therapy after cardiopulmonary bypass surgery: a predictive score from the Cardiac Surgery Registry of Puglia. Int J Cardiol. 2014;176(3):866-873. doi:10. 1016/j.ijcard.2014.08.003
16. Yılmaz A, Poyrazoglu H, Dursun I, et al. Evaluation of cases with renal failure followed in pediatric intensive care unit. Erciyes Med J. 2009; 31(3):231-236.
17. Leballo G, Chakane PM. Cardiac surgery-associated acute kidney injury: pathophysiology and diagnostic modalities and management. Cardiovasc J Afr. 2020;31(4):205-212. doi:10.5830/CVJA-2019-069 </ol> <p>
Volume 5, Issue 3, 2025
Page : 157-161
_Footer