Acute Kidney Injury in Children Following Cardiopulmonary Bypass: A Call for Action

Acute kidney injury (AKI) occurs frequently in children undergoing surgery for complex congenital heart disease and is associated with poor outcomes. Unfortunately, despite several decades’ worth of data delineating a strong epidemiologic signal for both high incidence and association with outcomes such as prolonged mechanical ventilation, high infection rates, and increased rates of death, very little progress has been made in reducing the reach and sequelae of the disease. In this chapter, elements of pathophysiology and epidemiology will be integrated into the perspectives of past, present, and future patient care. Existing views of the etiology and management of AKI will be challenged-ultimately shifting the AKI paradigm toward highlighting avenues of research and patient management requiring broadscale, multidisciplinary study, investment, and progress.