Incidence of acute kidney injury following cardiac catheterization prior to cardiopulmonary bypass in children

Nicholas Huggins, Alan Nugent, Vinai Modem, Joseph S. Rodriguez, Joseph Forbess, William Scott, V. Vivian Dimas*

*Corresponding author for this work

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objectives To determine whether contrast administration was a risk factor for development of acute kidney injury (AKI) in cyanotic congenital heart disease (CHD) patients undergoing cardiopulmonary bypass (CPB). Background AKI following CPB or contrast administration is well described. In previous studies, administration of contrast prior to CPB has been shown to increase the risk of AKI. Chronic cyanosis leads to glomerular damage and dysfunction, thus potentially placing this population at increased risk of developing AKI following contrast administration prior to CPB. Methods One hundred twenty-two patients with cyanotic CHD undergoing preoperative cardiac catheterization (PCC) and subsequent CPB at Children's Medical Center of Dallas from January 1, 2007 until November 30, 2010 were identified, looking specifically at bi-directional Glenn (BDG) anastomoses and Fontan procedures. One hundred thirteen patients undergoing PCC ≤ 48 hr prior to and > 5 days prior to CPB were included. Occurrence of AKI following CPB was the primary outcome variable. Results Logistic regression analysis revealed pre-catheterization serum creatinine was a risk factor for post-CPB AKI (P < 0.001) in both Fontan and BDG patients. All other variables were not significantly associated with the development of AKI in either BDG or Fontan patients. Length of stay (hospital or ICU) was not different among the groups regardless of the occurrence of AKI. Conclusions In this study of cyanotic CHD patients, contrast administration within 48 hr prior to CPB was not an additional risk factor for the development of AKI.

Original languageEnglish (US)
Pages (from-to)615-619
Number of pages5
JournalCatheterization and Cardiovascular Interventions
Volume84
Issue number4
DOIs
StatePublished - Oct 1 2014

Fingerprint

Cardiac Catheterization
Cardiopulmonary Bypass
Acute Kidney Injury
Incidence
Heart Diseases
Fontan Procedure
Cyanosis
Catheterization
Length of Stay
Creatinine
Logistic Models
Regression Analysis
Serum

Keywords

  • acute renal disease
  • congenital heart disease
  • contrast agents
  • surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Huggins, Nicholas ; Nugent, Alan ; Modem, Vinai ; Rodriguez, Joseph S. ; Forbess, Joseph ; Scott, William ; Dimas, V. Vivian. / Incidence of acute kidney injury following cardiac catheterization prior to cardiopulmonary bypass in children. In: Catheterization and Cardiovascular Interventions. 2014 ; Vol. 84, No. 4. pp. 615-619.
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Incidence of acute kidney injury following cardiac catheterization prior to cardiopulmonary bypass in children. / Huggins, Nicholas; Nugent, Alan; Modem, Vinai; Rodriguez, Joseph S.; Forbess, Joseph; Scott, William; Dimas, V. Vivian.

In: Catheterization and Cardiovascular Interventions, Vol. 84, No. 4, 01.10.2014, p. 615-619.

Research output: Contribution to journalArticle

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T1 - Incidence of acute kidney injury following cardiac catheterization prior to cardiopulmonary bypass in children

AU - Huggins, Nicholas

AU - Nugent, Alan

AU - Modem, Vinai

AU - Rodriguez, Joseph S.

AU - Forbess, Joseph

AU - Scott, William

AU - Dimas, V. Vivian

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N2 - Objectives To determine whether contrast administration was a risk factor for development of acute kidney injury (AKI) in cyanotic congenital heart disease (CHD) patients undergoing cardiopulmonary bypass (CPB). Background AKI following CPB or contrast administration is well described. In previous studies, administration of contrast prior to CPB has been shown to increase the risk of AKI. Chronic cyanosis leads to glomerular damage and dysfunction, thus potentially placing this population at increased risk of developing AKI following contrast administration prior to CPB. Methods One hundred twenty-two patients with cyanotic CHD undergoing preoperative cardiac catheterization (PCC) and subsequent CPB at Children's Medical Center of Dallas from January 1, 2007 until November 30, 2010 were identified, looking specifically at bi-directional Glenn (BDG) anastomoses and Fontan procedures. One hundred thirteen patients undergoing PCC ≤ 48 hr prior to and > 5 days prior to CPB were included. Occurrence of AKI following CPB was the primary outcome variable. Results Logistic regression analysis revealed pre-catheterization serum creatinine was a risk factor for post-CPB AKI (P < 0.001) in both Fontan and BDG patients. All other variables were not significantly associated with the development of AKI in either BDG or Fontan patients. Length of stay (hospital or ICU) was not different among the groups regardless of the occurrence of AKI. Conclusions In this study of cyanotic CHD patients, contrast administration within 48 hr prior to CPB was not an additional risk factor for the development of AKI.

AB - Objectives To determine whether contrast administration was a risk factor for development of acute kidney injury (AKI) in cyanotic congenital heart disease (CHD) patients undergoing cardiopulmonary bypass (CPB). Background AKI following CPB or contrast administration is well described. In previous studies, administration of contrast prior to CPB has been shown to increase the risk of AKI. Chronic cyanosis leads to glomerular damage and dysfunction, thus potentially placing this population at increased risk of developing AKI following contrast administration prior to CPB. Methods One hundred twenty-two patients with cyanotic CHD undergoing preoperative cardiac catheterization (PCC) and subsequent CPB at Children's Medical Center of Dallas from January 1, 2007 until November 30, 2010 were identified, looking specifically at bi-directional Glenn (BDG) anastomoses and Fontan procedures. One hundred thirteen patients undergoing PCC ≤ 48 hr prior to and > 5 days prior to CPB were included. Occurrence of AKI following CPB was the primary outcome variable. Results Logistic regression analysis revealed pre-catheterization serum creatinine was a risk factor for post-CPB AKI (P < 0.001) in both Fontan and BDG patients. All other variables were not significantly associated with the development of AKI in either BDG or Fontan patients. Length of stay (hospital or ICU) was not different among the groups regardless of the occurrence of AKI. Conclusions In this study of cyanotic CHD patients, contrast administration within 48 hr prior to CPB was not an additional risk factor for the development of AKI.

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