Incidence, Risk Factors, and Risk Model of Acute Kidney Injury in Pediatric Patients Who Undergoing Surgery for Congenital Heart Disease

Study Overview
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Brief Summary
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Acute kidney injury (AKI) is a major complication after cardiac surgery and has been reported to be associated with adverse outcome. Previous studies have reported that the incidence of AKI in patients undergoing surgery for congenital heart disease is as high as 42% and AKI increase the patient mortality, intensive care unit stay and hospital stay. Previous studies have reported several risk factors for AKI after congenital heart surgery, however, perioperative variables including anesthesia-related factors have not been evaluated fully. Therefore, the investigators attempt to find out independent risk factors regarding perioperative variables.

Detailed Description
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Acute kidney injury (AKI) is a major complication after cardiac surgery and has been reported to be associated with adverse outcome. Previous studies have reported that the incidence of AKI in patients undergoing surgery for congenital heart disease is as high as 42% and AKI increase the patient mortality, intensive care unit stay and hospital stay. Previous studies have reported several risk factors for AKI after congenital heart surgery, however, perioperative variables including anesthesia-related factors have not been evaluated fully. In addition, a neutrophil-lymphocyte ratio (NLR), which have been reported to be a marker for systemic inflammation and associated with prognosis of cardiac and cancer patients might be able to predict development of postoperative AKI. Therefore, the investigators attempt to assess independent risk factors regarding perioperative variables including transfusion-related parameters, preoperative anemia, preoperative hypoalbuminemia, pulmonary hypertension, use of nitric oxide, use of hydroxyethyl starch, perioperative medication, hemodynamic variables and perioperative NLR.

Official Title
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Incidence, Risk Factors, and Risk Model of Acute Kidney Injury in Pediatric Patients Who Undergoing Surgery for Congenital Heart Disease

Conditions
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Patients Undergoing Surgery for Congenital Heart Disease

Intervention / Treatment
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* Procedure: surgery for congenital heart disease


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients who underwent surgery for congenital heart disease between January 2012 and December 2012 in Samsung Medical Center Exclusion Criteria: incomplete data for creatinine, estimated glomerular filtration rate, or urine output required to diagnose acute kidney injury patients who expired within 24 hours after surgery

Ages Eligible for Study
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Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| patients who underwent surgery for congenital heart disease<br>patients who underwent surgery for congenital heart disease during 2012 in Samsung Medical Center | Procedure: surgery for congenital heart disease<br>* surgery for congenital heart disease<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acute kidney injury as defined by KDIGO (Kidney Disease: Improving Global outcome) criteria | Acute kidney injury as defined by KDIGO criteria (Stage 1, 2, 3) | during seven days after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acute kidney injury as defined by AKIN (acute kidney injury network) criteria | Acute kidney injury as defined by AKIN (acute kidney injury network) criteria within 48 hours after surgery | within 48 hours after surgery | 
| acute kidney injury diagnosis defined by RIFLE criteria | acute kidney injury diagnosis defined by RIFLE criteria (for Risk, Injury, Failure during seven days after surgery | during seven days after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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congenital heart disease, acute kidney injury, risk factor, anesthesia