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Development of acute kidney injury following pediatric cardiac surgery

Kidney Research and Clinical Practice 2020년 39권 3호 p.259 ~ 268
Sharma Aditya, Chakraborty Ronith, Sharma Katyayini, Sethi Sidharth K., Raina Rupesh,
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 ( Sharma Aditya ) - Northeast Ohio Medical University Department of Internal Medicine
 ( Chakraborty Ronith ) - Cleveland Clinic Akron General Medical Center Department of Nephrology
 ( Sharma Katyayini ) - Lincoln Memorial University DeBusk College of Osteopathic Medicine Department of Medicine
 ( Sethi Sidharth K. ) - Medicity Hospital Department of Pediatric Nephrology
 ( Raina Rupesh ) - Cleveland Clinic Akron General Medical Center Department of Nephrology

Abstract


Acute kidney injury (AKI) in the pediatric population is a relatively common phenomenon. Specifically, AKI has been found in increasing numbers within the pediatric population following cardiac surgery, with up to 43% of pediatric patients developing AKI post-cardiac surgery. However, recent advances have allowed for the identification of risk factors. These can be divided into preoperative, intraoperative, and postoperative factors. Although the majority of pediatric patients developing AKI after cardiac surgery completely recover, this condition is associated with worse outcomes. These include fluid overload and increased mortality and result in longer hospital and intensive care unit stays. Detecting the presence of AKI has advanced; use of relatively novel biomarkers, including neutrophil gelatinase associated lipocalin, has shown promise in detecting more subtle changes in kidney function when compared to conventional methods. While a single, superior treatment has not been elucidated yet, novel functions of medications, including fenoldopam, theophylline and aminophylline, have been shown to have better outcomes for these patients. With the recent advances in identification of risk factors, outcomes, diagnosis, and management, the medical community can further explain the complexities of AKI in the pediatric population post-cardiac surgery.

키워드

Acute kidney injury; Nephrology; Pediatrics; Thoracic surgery

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