Cardiac Surgery-Associated Acute Kidney Injury (CSA-AKI) in Adults and Pediatrics; Prevention is the Optimal Management.

Abstract

BACKGROUND Cardiac surgery-associated acute kidney injury (CSA-AKI) is a significant and severe complication that affects morbidity and mortality. We studied both pediatric and adult patients using the Acute Kidney Injury Network (AKIN) definition. METHODS This was an observational retrospective cohort study done at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, and approved by the 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. We included 941 patients in the analysis using statistical software SPSS, version 15.0. RESULTS Of the total number of patients, 28.68% in the adult group and 20.07% in the pediatric group developed CSA-AKI. Adult risk factors included the age group 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 were the main risk factors Conclusion: Conventional conservative management and preoperative identification of predictor risk factors are essential for preventing CSA-AKI, constituting the primary strategy for optimal management.