AIM To investigate the influencing factors of early acute kidney injury(AKI)in children with congenital heart disease associated with pulmonary arterial hypertension(CHD-PAH)after cardiopulmonary bypass (CPB).
METHODS A retrospective study was conducted on children under 3 years old who underwent cardiac surgery under CPB in our department from June 2016 to December 2020. All patients with CHD-PAH, were divided into AKI group and non-AKI group according to the occurrence of AKI after operation. The perioperative data were collected and statistically analyzed.
RESULTS A total of 299 children were included in this study. The incidence of postoperative AKI, was 20.7% and the mortality rate was 4.8%. Univariate Logistic regression analysis showed that age,height, weight, pulmonary infection, preoperative creatinine,intraoperative CPB time, aortic occlusion time and risk adjustment for congenital heart surgery-1(RACHS-1) were closely related to postoperative AKI (P < 0.05). Multivariate Logistic regression analysis showed that age, preoperative pulmonary infection, preoperative creatinine value and aortic occlusion time were independent risk factors for AKI. The postoperative complications such as secondary intubation, renal replacement therapy and blood flow infection in the AKI group were significantly higher than those in the non-AKI group. The time of mechanical ventilation, the stay time of ICU and the total hospital stay were significantly prolonged and the mortality was significantly increased.
CONCLUSION Low age, low body weight, low preoperative creatinine value, preoperative pulmonary infection and long aortic occlusion time are independent risk factors for postoperative AKI. Active preventive measures for high-risk groups may be an effective way to reduce the incidence of postoperative AKI and improve clinical prognosis.
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