The following is a summary of “Long-Term Consequences of Acute Kidney Injury After Pediatric Cardiac Surgery: A Systematic Review,” published in the JANUARY 2023 issue of Pediatrics by Eynde, et al.

For a study, researchers sought to assess the current available information regarding mortality following acute kidney injury (AKI) linked with cardiac surgery, hypertension, and long-term kidney dysfunction in the juvenile population.

Searches were conducted for appropriate research published from the beginning to March 2022 in PubMed/MEDLINE, Embase, Scopus, and reference lists of pertinent articles. In addition, we looked at the long-term results of juvenile heart surgery with and without AKI complications.

About 14 studies with 6,701 patients were found and published between 2013 and 2022 (AKI: 1,376 patients; no AKI: 5,325 patients). These studies defined AKI according to various accepted classifications. All studies indicated that AKI following cardiac surgery is frequent in the juvenile patient group and that there may be a connection between cardiac surgery-related AKI and significant clinical outcomes. However, only 4 out of 11 studies discovered a strong correlation between the risk of developing chronic kidney disease and (lack of recovery from) AKI related to cardiac surgery, and 3 out of 5 studies discovered a significant rise in mortality rates for pediatric patients who experienced AKI after cardiac surgery. In addition, only one out of four investigations discovered a link between AKI and hypertension 12 months after surgery, but no connection was discovered at further follow-up intervals.

Although there was a tendency, there was conflicting information regarding the long-term effects of AKI by cardiac surgery in children. For the development of renal dysfunction by adolescence and early adulthood, genetic disorders, preexisting kidney disease, univentricular or cyanotic heart problems, and/or high-complexity surgery may be more significant factors for the development of renal dysfunction by adolescence and early adulthood. Regardless, a long-term kidney follow-up for these kids would be advantageous.

Reference: jpeds.com/article/S0022-3476(22)00795-8/fulltext