Seminars in Nephrology
Volume 28, Issue 5 , Pages 470-476, September 2008

Acute Kidney Injury in an Infant After Cardiopulmonary Bypass

  • Stefano Picca, MD

      Affiliations

    • Department of Nephrology and Urology, Dialysis Unit, “Bambino Gesù” Children's Research Hospital, Rome, Italy
    • Corresponding Author InformationAddress reprint requests to Stefano Picca, MD, Department of Nephrology and Urology, Dialysis Unit, “Bambino Gesù” Children's Research Hospital, Piazza S. Onofrio, 4, 00165 Rome, Italy
    • ,
  • Zaccaria Ricci, MD

      Affiliations

    • Cardiosurgery Intensive Care Unit, “Bambino Gesù” Children's Research Hospital, Rome, Italy
    • ,
  • Sergio Picardo, MD

      Affiliations

    • Cardiosurgery Intensive Care Unit, “Bambino Gesù” Children's Research Hospital, Rome, Italy

Summary 

The infant who develops acute kidney injury (AKI) after cardiopulmonary bypass (CPB) surgery presents unique challenges and opportunities to the clinician and to the investigator interested in the study of AKI pathophysiology. Infants do not have many of the comorbid conditions that confound CPB outcome studies of adults. Because the timing of the AKI event is known in this clinical setting, collaboration between cardiology intensivists, nephrologists, and perfusion technologists is essential to minimize the impact of CPB on the kidney. Early institution of ultrafiltration in the operating room and renal replacement therapy in the postoperative period may decrease the proinflammatory milieu and its resultant systemic effects. In addition, early initiation of renal replacement therapy to prevent fluid overload may result in improved infant outcomes.

Keywords: Acute kidney injury, pediatric cardiac surgery, cardiopulmonary bypass, continuous renal replacement therapy

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PII: S0270-9295(08)00114-9

doi:10.1016/j.semnephrol.2008.05.006

Seminars in Nephrology
Volume 28, Issue 5 , Pages 470-476, September 2008

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