Analysis Of Risk Factors For Acute Kidney Injury In Infants And Young Children Unnergoing Cardiopulmonary Bypass

Obiective:To identify the risk facts of acute kidney injury(AKI) in infants and young children after cardiac surgery with cardiopulmonary bypass(CPB).Methods:161patients aged<3yrs undergoing CPB were reviewed retrospectively according to the clinical data from September,2012to January,2013According to the definition of AKI, they were divided into two groups:AKI group and non-AKI group. After univariate analysis, a binary logistic regression analysis was used to evaluate the independent risk factors for AKI after CPB. The predictive ability of risk factors for AKI was assessed using an area under the receiver operating characteristic(ROC) curve.Results:(1)23patients required AKI after cardiac surgery, with the incidendce rate of14.3%.(2) Univariate analysis showed that age, weight, preoperative serum concentration of cystatin C, duration of CPB time, duration of aortic cross-clamp, postponed sternal closure, RACHS-1, postoperative serum creatinine (Scr), postoperative serum cystatin C, inotropic score(IS), postoperative mechanical ventilation time, postoperative pulmonary hypertension, and postoperative nosocomial pheumonias were related to the development of AKI (P<0.05). Logistic regression analysis showed that the independent risk factors for AKI were postoperative serum cystatin C≥1.02mg/L, weight≤5kg and Scr≥35.6μmol/L, with odd ratios of8.947,6.567and5.387.The value for the ROC curve was0.937.Conclusions:(1) High risk population might be found out through preoperative evaluation of age,weight and serum cystatin C before CPB.(2)The present results strongly suggest that postoperative serum cystatin C, weight and postoperative Scr are risk factors of AKI after CPB, and may allow for the reliable eary diagnosis and prognosis of AKI.(3) During the period from September2012to January2013, the main postoperative nosocomial pheumonias were viruses, early antivirus therapy may play an important role in reducing the rate of AKI.