Abstract
Aims & Objectives: objectives: To determine the frequency, risk factors and outcome of AKI in post-operative patients undergone CPB surgery for congenital heart defects. Methods We conducted a retrospective Matched (age and gender) case control study 1:1 with a sample size of 474 (237 cases and 237 controls). We used the KHIGO criteria to define acute kidney injury. Severe acute kidney injury was defined as stage 2 or 3 acute kidney injury (plasma creatinine level ≥2 times the baseline level or urine output <0.5 ml per kilogram of body weight per hour for ≥12 hours) and was assessed for the first 7 days of intensive care. Data was collected on a structured proforma and all the preoperative, intraoperative, postoperative and follow up details were collected. P value along with odds ratio and 95% confidence interval were reported. Results A total of 840 patients underwent CPB surgery, 237(28%) patients developed AKI. Stage II & III were seen the most, 101(42%) and 103(43%) respectively. Prolonged cardiopulmonary bypass time (AOR: 1.013, 95% CI: 1.008- 1,019, p value < 0.005) and cyanotic heart diseases (AOR: 1.87, 95% CI: 1.18- 2.97, p value 0.008) were found to be significant risk factors on multivariate analysis. 227(95%) patients showed resolution. 4(2%) patients required peritoneal dialysis. 10 (5%) patients expired had associated multiorgan failure. No patients with resolution were followed in clinic for assessment of renal function. Conclusions AKI in post-operative cardiac surgery patients is common. It can be prevented by avoiding the prolong cardiopulmonary bypass time and early repair in cyanotic heart diseases.
Published Version
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