Abstract
To our knowledge there are no case-control studies that have examined the main risk factors for acute renal failure (ARF) following cardiopulmonary bypass surgery in children. We therefore evaluated the potential risk factors in a large retrospective case-control study. Sixty-one of 2262 children (2.7%) developed postcardiopulmonary bypass surgery ARF requiring peritoneal dialysis (PD) from 1982 to 1991. Fifty-eight of 61 cases (median age 8.5 months) were selected by systematic sampling and matched with 176 controls who did not develop ARF. The four matching variables were age, cardiopulmonary bypass and circulatory arrest duration, and year of operation. Mortality rate was 79% in cases (controls: 18%). Forty-three of 48 of the deceased cases did not recover renal function; no renal cause of death was found; 13 of 61 cases survived and recovered renal function. Multiple regression analysis showed the following significant risk factors for postcardiopulmonary bypass surgery ARF: central venous hypertension >12 h (odds ratio (OR) 9.6); systolic arterial hypotension >12 h (OR 8.9); dopamine dosage >15 μg/kg/min (OR 3.0); adrenaline (OR 5.9) and isoproterenol (OR 13.5) use. High preoperative serum creatinine, cyanosis, and vasodilator use were not significant risk factors. We conclude that: (1) haemodynamic alterations were the main cause of postcardiopulmonary bypass surgery ARF; (2) ARF was associated with but was not the cause of the high mortality rate; (3) the risk of ARF increased almost 10-fold after 12 h of central venous hypertension and/or of systolic arterial hypotension; (4) effective dosages of inotropes might have been a risk factor for ARF; (5) a slight precardiopulmonary bypass surgery reduction of renal function alone did not represent an increased risk for ARF.
| Original language | English |
|---|---|
| Pages (from-to) | 630-636 |
| Number of pages | 7 |
| Journal | Nephrology Dialysis Transplantation |
| Volume | 10 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 1995 |
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Keywords
- Acute renal failure
- Children
- Open heart surgery
- Peritoneal dialysis
ASJC Scopus subject areas
- Nephrology
- Transplantation
Cite this
Risks of acute renal failure after cardiopulmonary bypass surgery in children : a retrospective 10-year case-control study. / Picca, S.; Principato, F.; Mazzera, E.; Corona, R.; Ferrigno, L.; Marcelletti, C.; Rizzoni, G.
In: Nephrology Dialysis Transplantation, Vol. 10, No. 5, 1995, p. 630-636.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Risks of acute renal failure after cardiopulmonary bypass surgery in children
T2 - a retrospective 10-year case-control study
AU - Picca, S.
AU - Principato, F.
AU - Mazzera, E.
AU - Corona, R.
AU - Ferrigno, L.
AU - Marcelletti, C.
AU - Rizzoni, G.
PY - 1995
Y1 - 1995
N2 - To our knowledge there are no case-control studies that have examined the main risk factors for acute renal failure (ARF) following cardiopulmonary bypass surgery in children. We therefore evaluated the potential risk factors in a large retrospective case-control study. Sixty-one of 2262 children (2.7%) developed postcardiopulmonary bypass surgery ARF requiring peritoneal dialysis (PD) from 1982 to 1991. Fifty-eight of 61 cases (median age 8.5 months) were selected by systematic sampling and matched with 176 controls who did not develop ARF. The four matching variables were age, cardiopulmonary bypass and circulatory arrest duration, and year of operation. Mortality rate was 79% in cases (controls: 18%). Forty-three of 48 of the deceased cases did not recover renal function; no renal cause of death was found; 13 of 61 cases survived and recovered renal function. Multiple regression analysis showed the following significant risk factors for postcardiopulmonary bypass surgery ARF: central venous hypertension >12 h (odds ratio (OR) 9.6); systolic arterial hypotension >12 h (OR 8.9); dopamine dosage >15 μg/kg/min (OR 3.0); adrenaline (OR 5.9) and isoproterenol (OR 13.5) use. High preoperative serum creatinine, cyanosis, and vasodilator use were not significant risk factors. We conclude that: (1) haemodynamic alterations were the main cause of postcardiopulmonary bypass surgery ARF; (2) ARF was associated with but was not the cause of the high mortality rate; (3) the risk of ARF increased almost 10-fold after 12 h of central venous hypertension and/or of systolic arterial hypotension; (4) effective dosages of inotropes might have been a risk factor for ARF; (5) a slight precardiopulmonary bypass surgery reduction of renal function alone did not represent an increased risk for ARF.
AB - To our knowledge there are no case-control studies that have examined the main risk factors for acute renal failure (ARF) following cardiopulmonary bypass surgery in children. We therefore evaluated the potential risk factors in a large retrospective case-control study. Sixty-one of 2262 children (2.7%) developed postcardiopulmonary bypass surgery ARF requiring peritoneal dialysis (PD) from 1982 to 1991. Fifty-eight of 61 cases (median age 8.5 months) were selected by systematic sampling and matched with 176 controls who did not develop ARF. The four matching variables were age, cardiopulmonary bypass and circulatory arrest duration, and year of operation. Mortality rate was 79% in cases (controls: 18%). Forty-three of 48 of the deceased cases did not recover renal function; no renal cause of death was found; 13 of 61 cases survived and recovered renal function. Multiple regression analysis showed the following significant risk factors for postcardiopulmonary bypass surgery ARF: central venous hypertension >12 h (odds ratio (OR) 9.6); systolic arterial hypotension >12 h (OR 8.9); dopamine dosage >15 μg/kg/min (OR 3.0); adrenaline (OR 5.9) and isoproterenol (OR 13.5) use. High preoperative serum creatinine, cyanosis, and vasodilator use were not significant risk factors. We conclude that: (1) haemodynamic alterations were the main cause of postcardiopulmonary bypass surgery ARF; (2) ARF was associated with but was not the cause of the high mortality rate; (3) the risk of ARF increased almost 10-fold after 12 h of central venous hypertension and/or of systolic arterial hypotension; (4) effective dosages of inotropes might have been a risk factor for ARF; (5) a slight precardiopulmonary bypass surgery reduction of renal function alone did not represent an increased risk for ARF.
KW - Acute renal failure
KW - Children
KW - Open heart surgery
KW - Peritoneal dialysis
UR - http://www.scopus.com/inward/record.url?scp=0029001982&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0029001982&partnerID=8YFLogxK
U2 - 10.1093/oxfordjournals.ndt.a091186
DO - 10.1093/oxfordjournals.ndt.a091186
M3 - Article
C2 - 7566574
AN - SCOPUS:0029001982
VL - 10
SP - 630
EP - 636
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
SN - 0931-0509
IS - 5
ER -