Summary
Acute kidney injury after cardiac surgery (CS-AKI) is common in neonatal and pediatric
populations and is a risk factor for poor outcomes, such as mortality and increased
hospital resource utilization. This review presents a summary of CS-AKI risk factors,
integration of biomarkers, and the need to improve risk stratification for targeting
future clinical trials. To date, studies examining CS-AKI risk factors cannot be generalized
easily owing to variability in patient age, surgical complexity or population, AKI
definition, and center-specific practices. However, certain risk associations, such
as younger age at surgery, history of prematurity, cardiopulmonary bypass time, and
surgical complexity, have been identified across multiple, but not all, studies. CS-AKI
appears to have different severity and duration phenotypes, and serum creatinine is
limited in its ability to identify CS-AKI early and predict CS-AKI course. Treatment
strategies are largely supportive, and efforts are ongoing to use biomarkers and clinical
features to risk-stratify patients, which in turn may facilitate differential CS-AKI
phenotyping and management with supportive care bundles, clinical decision support
techniques, and modulation of modifiable risk factors.
Keywords
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Article info
Publication history
Published online: January 04, 2023
Footnotes
Financial support: None.
Conflict of interest statement: Katja M. Gist is a consultant for Bioporto Diagnostics and Potrero Medical, Inc; and received speaker honoraria from Medtronic. Neither Bioporto nor otrero Medical participated in the writing of this manuscript or provided input into its content.
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