Objective: There is an increased risk of mortality in patients in whom acute kidney injury and fluid accumulation develop after cardiothoracic surgery, and the risk is especially high when renal replacement therapy is needed. However, renal replacement therapy remains an essential intervention in managing these patients. The objective of this study was to identify risk factors for mortality in surgical patients requiring renal replacement therapy in a pediatric cardiac intensive care unit.
Methods: We performed a retrospective review of patients requiring renal replacement therapy for acute kidney injury or fluid accumulation after cardiothoracic surgery between January 2009 and December 2017. Survivors and nonsurvivors were compared with respect to multiple variables, and a multivariable logistic regression analysis was performed to identify independent risk factors associated with mortality.
Results: The mortality rate for the cohort was 75%. Nonsurvivors were younger (nonsurvivors: 0.8 years; interquartile range, 0.1-8.2; survivors: 14.6 years; interquartile range, 4.2-19.7; P = .002) and had a lower weight-for-age z-score (nonsurvivors: -1.5; interquartile range, -3.1 to -0.4; survivors: -0.5; interquartile range, -0.9 to 0.3; P = .02) compared with survivors. There was no difference with respect to fluid accumulation. In multivariable analysis, a longer duration of stage 3 acute kidney injury before initiation of renal replacement therapy was independently associated with mortality (adjusted odds ratio, 1.39; 95% confidence interval, 1.05-1.83; P = .021).
Conclusions: Mortality in patients requiring renal replacement therapy after congenital heart disease surgery is high. A longer duration of acute kidney injury before renal replacement therapy initiation is associated with increased mortality.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jtcvs.2019.06.061 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Introduction: Patients with end-stage renal disease usually undergo hemodialysis as a way of renal function replacement therapy which comes with a wide array of systemic and cutaneous complications. The aim of this study was to evaluate the most frequent dermatological manifestations including xerosis, pruritis and other nail, hair and oral conditions, as these are a very important aspect to be considered while managing the patients psychological and physical needs to improve their outcomes and quality of life.
Methods: This retrospective cross-sectional study was performed by selecting 77 patients on hemodialysis based on a certain criteria and data was then collected on a sheet using patients database on Hakeem National E-Health Program, in addition to information from interviews with patients during their hemodialysis sessions after taking an oral informed consent and insuring patients' privacy.
Prognostic value of CHA2DS2-VASc score for in-hospital outcomes in patients with Takotsubo syndrome.
Cardiovasc Revasc Med
December 2024
Division of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University and Lifespan Cardiovascular Institute, Providence, RI, USA.
Background: There is uncertainty about the use of the CHA2DS2-VASc score to predict clinical events in patients with Takotsubo syndrome (TTS). This study aimed to assess the short-term prognostic role of CHA2DS2-VASc score in this population.
Methods: All admissions with a primary diagnosis of TTS were included using data from the National Inpatient Sample database during 2016-2019.
Acquired cystic kidney disease in children with kidney failure.
Pediatr Nephrol
January 2025
Paediatric Nephrology Centre, Hong Kong Children's Hospital, Hong Kong, Hong Kong SAR.
Background: This study aimed to evaluate the incidence, contributing factors, and clinical outcomes of acquired cystic kidney disease (ACKD) in children undergoing kidney replacement therapy (KRT).
Methods: We conducted a cross-sectional, territory-wide study at the designated pediatric nephrology center in Hong Kong. ACKD was defined as the presence of ≥ 3 cysts in the native kidneys, excluding congenital or hereditary cystic diseases.
Major Adverse Kidney Events in Hospitalized Older Patients With Acute Kidney Injury: Machine Learning-Based Model Development and Validation Study.
J Med Internet Res
January 2025
Department of Nephrology, Hunan Key Laboratory of Kidney Disease and Blood Purification, The Second Xiangya Hospital of Central South University, Changsha, China.
Background: Acute kidney injury (AKI) is a common complication in hospitalized older patients, associated with increased morbidity, mortality, and health care costs. Major adverse kidney events within 30 days (MAKE30), a composite of death, new renal replacement therapy, or persistent renal dysfunction, has been recommended as a patient-centered endpoint for clinical trials involving AKI.
Objective: This study aimed to develop and validate a machine learning-based model to predict MAKE30 in hospitalized older patients with AKI.
Mortality Risk Prediction Models for People With Kidney Failure: A Systematic Review.
JAMA Netw Open
January 2025
Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Importance: People with kidney failure have a high risk of death and poor quality of life. Mortality risk prediction models may help them decide which form of treatment they prefer.
Objective: To systematically review the quality of existing mortality prediction models for people with kidney failure and assess whether they can be applied in clinical practice.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!