Connecting Brain and Kidney: The Systemic Effects of Acute Kidney Injury After Cardiac Surgery

Abstract

Acute kidney injury (AKI) is a common complication after pediatric cardiac surgery, occurring in at least 50% of children.1,2 While the association between cardiac surgery-associated AKI (CS-AKI) and short term outcomes, such as prolonged mechanical ventilation, prolonged intensive care unit (ICU) length of stay, and mortality, have been demonstrated, how CS-AKI impacts individual risk for long-term morbidity in this population is poorly understood.1,2 Children with congenital heart disease (CHD) are known to be at risk for developmental delays for a variety of well- characterized individual, preoperative, and postoperative factors,3 and AKI itself has been proposed to cause direct brain injury through endothelial activation and disruption of the blood-brain barrier.