Risk factors for acute kidney injury after pediatric cardiac surgery: a meta-analysis.
Background: Cardiac surgery-associated acute kidney injury (AKI) is associated with increased morbidity and mortality in both adults and children. Objectives: This study aimed to identify clinical risk factors for AKI following cardiac surgery in the pediatric population. Data sources: PubMed/MEDLIN...
| Publicado en: | Pediatric Nephrology Vol. 37; no. 3; pp. 509 - 520 |
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| Autores principales: | , , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Springer Nature
Mar2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=155757711&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 155757711 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Mar2022 vid: 37 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 155757711 152725604 155757711 155757711 10.1007/s00467-021-05297-0 155757711 ppf: 509 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Risk factors for acute kidney injury after pediatric cardiac surgery: a meta-analysis. aug: au: Van den Eynde, Jef Delpire, Boris Jacquemyn, Xander Pardi, Ismat Rotbi, Hajar Gewillig, Marc Kutty, Shelby Mekahli, Djalila affil: Helen B. Taussig Heart Center, The Johns Hopkins Hospital and School of Medicine, Baltimore, USA sug: subj: Kidney Failure, Acute Risk Factors Risk Assessment Cardiac Surgery Adverse Effects Cardiac Surgery Adverse Effects Human Systematic Review Meta Analysis PubMed Medline Embase Child Adolescence Confidence Intervals Hypertension, Pulmonary Cyanosis Heart Diseases Univentricular Heart Heart Defects, Congenital Surgery Vasoconstrictor Agents Therapeutic Use Cardiopulmonary Bypass Reoperation Sepsis Age Factors Thinness Creatinine Preoperative Period Glomerular Filtration Rate Erythrocyte Transfusion Length of Stay Surgical Patients Child: 6-12 years Adolescent: 13-18 years ab: Background: Cardiac surgery-associated acute kidney injury (AKI) is associated with increased morbidity and mortality in both adults and children. Objectives: This study aimed to identify clinical risk factors for AKI following cardiac surgery in the pediatric population. Data sources: PubMed/MEDLINE, Embase, Scopus, and reference lists of relevant articles were searched for studies published by August 2020. Study eligibility criteria: Studies were included if (1) the population consisted of pediatric patients (< 18 years old), (2) patients underwent cardiac surgery, (3) risk factors were compared between patients who developed AKI and those who did not, and (4) studies were prospective or retrospective observational studies or randomized controlled trials. Participants and interventions: Children undergoing pediatric cardiac surgery. Study appraisal and synthesis methods: Random-effects meta-analysis was performed, comparing potential risk factors between pediatric patients who developed CS-AKI and those who did not. Results: Sixty-one publications including a total of 19,680 participants (AKI: 7257 participants; no AKI: 12,423 participants) were included from studies published between 2008 and 2020. The pooled estimated incidence of AKI was 34.3% (95% confidence interval 30.0–38.8%, I2 = 96.8%). Binary risk factors that were significantly and consistently associated with AKI were the presence of pulmonary hypertension, cyanotic heart disease, univentricular heart, risk adjustment for congenital heart surgery 1 (RACHS-1) score ≥ 3, vasopressor use, cardiopulmonary bypass use, reoperation, and sepsis. Significant continuous risk factors included younger age, lower body weight, lower preoperative creatinine, higher preoperative estimated glomerular filtration rate (eGFR), higher RACHS-1 score, longer surgery time, longer cardiopulmonary bypass time, longer aortic cross-clamp time, and higher red blood cell transfusion volume. Limitations: Results are limited by heterogeneity and potential residual confounding. Conclusions and implications of key findings: Our meta-analysis identified clinical risk factors that are associated with AKI in children undergoing cardiac surgery. This might help clinicians anticipate and manage more carefully this population and implement standardized preventive strategies. Systematic review registration number: CRD42021262699. A higher resolution version of the Graphical abstract is available as Supplementary information. pubtype: Academic Journal doctype: meta analysis research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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