Cardiac surgery-associated acute kidney injury (CSA-AKI) in adults and pediatrics; prevention is the optimal management.

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Abstract

Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is an important and serious complication that affects morbidity and mortality. We studied both pediatric and adults using the definition of the Acute Kidney Injury Network (AKIN). Methods: This is an observational retrospective cohort study done at King Abdulaziz University Hospital in Jeddah, Saudi Arabia approved by ethical committee. The exclusion criteria were baseline serum creatinine (SCr) ≥ 4 mg/dL or preexisting renal failure requiring dialysis, reoperation, death within 24 hours postoperatively, and operative mortality or missing data. 941 patients were included in the analysis using the statistical software  SPSS , version 15.0. Results: 28.68% in the adult group and 20.07% in the pediatric group developed CSA-AKI. Adult risk factors included age group of 60-69 years, cardiopulmonary bypass (CPB), number of grafts and hypertension. In the pediatric group, CPB, aortic cross-clamping (ACX) and the lower preoperative SCr are the main risk factors Conclusion: Conventional conservative management and preoperative Identification of predictor risk factors are essential for prevention of CSA-AKI which constitute the main strategy for optimal management.

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