Transient and persistent acute kidney injury phenotypes following the Norwood operation: a retrospective study

Katja M. Gist*, Santiago Borasino, Megan Soohoo, Danielle E. Soranno, Emily Mack, Kristal M. Hock, A. K.M.Fazlur Rahman, John T. Brinton, Rajit K. Basu, Jeffrey A. Alten

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Background: Acute kidney injury is a common complication following the Norwood operation. Most neonatal studies report acute kidney injury peaking within the first 48 hours after cardiac surgery. The aim of this study was to evaluate if persistent acute kidney injury (>48 postoperative hours) after the Norwood operation was associated with clinically relevant outcomes. Methods: Two-centre retrospective study among neonates undergoing the Norwood operation. Acute kidney injury was initially identified as developing within the first 48 hours after cardiac surgery and stratified into transient (≤48 hours) and persistent (>48 hours) using the neonatal modification of the Kidney Disease: Improving Global Outcomes serum creatinine criteria. Severe was defined as stage ≥2. Primary and secondary outcomes were mortality and duration of ventilation and hospital length of stay. Results: One hundred sixty-eight patients were included. Transient and persistent acute kidney injuries occurred in 24 and 17%, respectively. Cardiopulmonary bypass and aortic cross clamp duration, and incidence of cardiac arrest were greater among those with persistent kidney injury. Mortality was four times higher (41 versus 12%, p < 0.001) and mechanical ventilation duration 50 hours longer in persistent acute kidney injury patients (158 versus 107 hours; p < 0.001). In multivariable analysis, persistent acute kidney injury was not associated with mortality, duration of ventilation or length of stay. Severe persistent acute kidney injury was associated with a 59% increase in expected ventilation duration (aIRR:1.59, 95% CI:1.16, 2.18; p = 0.004). Conclusions: Future large studies are needed to determine if risk factors and outcomes change by delineating acute kidney injury into discrete timing phenotypes.

Original languageEnglish (US)
Pages (from-to)564-571
Number of pages8
JournalCardiology in the young
Issue number4
StatePublished - Apr 8 2022


  • Acute kidney injury
  • Norwood operation
  • neonatal
  • outcomes
  • persistent
  • transient

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Transient and persistent acute kidney injury phenotypes following the Norwood operation: a retrospective study'. Together they form a unique fingerprint.

Cite this