Incidence and impact of acute kidney injury in patients with hypoplastic left heart syndrome following the hybrid stage 1 palliation.

Autor:	Cunningham TW; The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA., Tan Y; Center for Biostatistics, College of Medicine, The Ohio State University, Columbus, OH, USA., Krawczeski CD; The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA., Spencer JD; Section of Nephrology, Nationwide Children's Hospital, Columbus, OH, USA., Bai S; Center for Biostatistics, College of Medicine, The Ohio State University, Columbus, OH, USA., Phelps C; The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA., Yates AR; The Heart Center, Nationwide Children's Hospital, Columbus, OH, USA.
Jazyk:	angličtina
Zdroj:	Cardiology in the young [Cardiol Young] 2021 Feb; Vol. 31 (3), pp. 414-420. Date of Electronic Publication: 2020 Dec 02.
DOI:	10.1017/S1047951120004199
Abstrakt:	Objective: Acute kidney injury leads to worse outcomes following paediatric cardiac surgery. There is a lack of literature focusing on acute kidney injury after the Hybrid stage 1 palliation for single ventricle physiology. Patients undergoing the Hybrid Stage 1, as a primary option, may have a lower incidence of kidney injury than previously reported. When present, kidney injury may increase the risk of post-operative morbidity and mortality. Methods: A retrospective, single centre review was conducted in patients with hypoplastic left heart syndrome who underwent Hybrid Stage 1 from 2008 to 2018. Acute kidney injury was defined as a dichotomous yes (meeting any injury criteria) or no (no injury) utilising two different criteria utilised in paediatrics. The impact of kidney injury on perioperative characteristics and 30-day mortality was analysed. Results: The incidence of acute kidney injury is 13.4-20.7%, with a severe injury rate of 2.4%. Patients without a prenatal diagnosis of hypoplastic left heart syndrome have a higher incidence of kidney injury than those prenatally diagnosed, (40% versus 14.5%, p = 0.024). Patients with acute kidney injury have a significantly higher incidence of 30-day mortality, 27.3%, compared to without, 5.6% (p = 0.047). Discussion: The incidence of severe acute kidney injury after the Hybrid Stage 1 palliation is low. A prenatal diagnosis may be associated with a lower incidence of kidney injury following the Hybrid Stage 1. Though uncommon, severe acute kidney injury following Hybrid Stage 1 may be associated with higher 30-day mortality.
Databáze:	MEDLINE
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