Hyperchloremia Is Not an Independent Risk Factor for Postoperative Acute Kidney Injury in Pediatric Cardiac Patients
| Autor: | Yasutoshi Kuroe, Tatsuo Iwasaki, Satoshi Kimura, Satoshi Isoyama, Tomoyuki Kanazawa, Hirokazu Kawase, Hiroshi Morimatsu, Yuto Matsuoka, Naohiro Shioji, Kazuyoshi Shimizu |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty 030204 cardiovascular system & hematology urologic and male genital diseases 03 medical and health sciences 0302 clinical medicine Hyperchloremia Postoperative Complications Risk Factors Internal medicine medicine Serum chloride Humans Risk factor Cardiac Surgical Procedures Retrospective Studies Univariate analysis urogenital system business.industry Acute kidney injury Infant 030208 emergency & critical care medicine Odds ratio Acute Kidney Injury medicine.disease Cardiac surgery Anesthesiology and Pain Medicine Child Preschool Female Chlorine Cardiology and Cardiovascular Medicine business Kidney disease |
| Zdroj: | Journal of cardiothoracic and vascular anesthesia. 33(7) |
| ISSN: | 1532-8422 |
| Popis: | Objective Hyperchloremia recently has been shown to have an association with the development of acute kidney injury (AKI) in critically ill patients. However, there is little information about the prevalence of an abnormal chloride concentration after pediatric cardiac surgery and its association with postoperative AKI. The aim of this study was to determine the prevalence of hyperchloremia and its association with AKI in pediatric patients after cardiac surgery. Design A retrospective single-center study. Setting Referral high-volume pediatric cardiac center in a tertiary teaching hospital. Participants Patients under 72 months of age with congenital heart disease who underwent cardiac surgery with the use of cardiopulmonary bypass. Interventions None. Measurements and main results The primary outcome was development of AKI diagnosed by Kidney Disease Improving Global Outcomes consensus criteria. The associations of outcomes with the highest serum chloride concentration ([Cl-]max) and time-weighted average chloride concentration ([Cl-]ave) within the first 48 hours after surgery were investigated. Of 521 patients included in the study, 463 patients (88.9%) had hyperchloremia at least 1 time within the first 48 hours after surgery. Postoperative AKI occurred in 205 patients (39.3%). [Cl-]ave and [Cl-]max in the AKI group were significantly higher than those in the non-AKI group (112 [110-114] mEq/L v 111 [109-113] mEq/L, p = 0.001 and 116 [113, 119] mEq/L v 114 [112-118] mEq/L, p = 0.002, respectively). After adjustment for other predictors of AKI by multivariable analyses, neither [Cl-]ave nor [Cl-]max was associated independently with the development of AKI (odds ratio [OR] = 1.040, 95% confidence interval [CI]: 0.885-1.220, p = 0.63; OR = 0.992, 95% CI: 0.874-1.130. p = 0.90). Conclusion Postoperative hyperchloremia was common and was associated with the development of AKI in pediatric patients after congenital cardiac surgery in univariate analysis. After adjustment for predictors of AKI by multivariate analyses, there was no significant relationship between postoperative chloride concentration and AKI. |
| Databáze: | OpenAIRE |
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