Journal article
Acute kidney injury is associated with subsequent infection in neonates after the Norwood procedure: a retrospective chart review
Pediatric nephrology (Berlin, West), Vol.33(7), pp.1235-1242
07/01/2018
DOI: 10.1007/s00467-018-3907-5
PMCID: PMC6326095
PMID: 29508077
Abstract
Background Acute kidney injury (AKI) and infection are common complications after pediatric cardiac surgery. No pediatric study has evaluated for an association between postoperative AKI and infection. The objective of this study was to determine if AKI in neonates after cardiopulmonary bypass was associated with the development of a postoperative infection. Methods We performed a single center retrospective chart review from January 2009 to December 2015 of neonates (age = 30 days) undergoing the Norwood procedure. AKI was defined by the modified neonatal Kidney Disease Improving Global outcomes serum creatinine criteria using (1) measured serum creatinine and (2) creatinine corrected for fluid balance on postoperative days 1-4. Infection, (culture positive or presumed), must have occurred after a diagnosis of AKI and within 60 days of surgery. Results Ninety-five patients were included, of which postoperative infection occurred in 42 (44%). AKI occurred in 38 (40%) and 42 (44%) patients by measured serum creatinine and fluid overload corrected creatinine, respectively, and was most commonly diagnosed on postoperative day 2. The median time to infection from the time of surgery and AKI was 7 days (IQR 5-14 days) and 6 days (IQR 3-13 days), respectively. After adjusting for confounders, the odds of a postoperative infection were 3.64 times greater in patients with fluid corrected AKI (95% CI, 1.36-9.75; p = 0.01). Conclusions Fluid corrected AKI was independently associated with the development of a postoperative infection. These findings support the notion that AKI is an immunosuppressed state that increases the risk of infection.
Details
- Title: Subtitle
- Acute kidney injury is associated with subsequent infection in neonates after the Norwood procedure: a retrospective chart review
- Creators
- Megan SooHoo - Children's Hospital ColoradoBenjamin Griffin - University of Colorado DenverAnna Jovanovich - Denver VA Medical CenterDanielle E. Soranno - Children's Hospital ColoradoEmily Mack - Children's Hospital ColoradoSonali S. Patel - Children's Hospital ColoradoSarah Faubel - University of Colorado SystemKatja M. Gist - University of Colorado System
- Resource Type
- Journal article
- Publication Details
- Pediatric nephrology (Berlin, West), Vol.33(7), pp.1235-1242
- Publisher
- Springer Nature
- DOI
- 10.1007/s00467-018-3907-5
- PMID
- 29508077
- PMCID
- PMC6326095
- ISSN
- 0931-041X
- eISSN
- 1432-198X
- Number of pages
- 8
- Grant note
- Pediatric Kidney Injury and Disease Stewardship (PKIDS) Program T32DK007135 / NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) Heart Institute at Children's Hospital Colorado
- Language
- English
- Date published
- 07/01/2018
- Academic Unit
- Nephrology; Internal Medicine
- Record Identifier
- 9984359953902771
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