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Follow-up after neonatal heart disease repair: watch out for chronic kidney disease and hypertension!
- Source :
-
Pediatric Nephrology . Nov2020, Vol. 35 Issue 11, p2137-2145. 9p. 1 Diagram, 1 Chart, 2 Graphs. - Publication Year :
- 2020
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Abstract
- Background: With advances in care, neonates undergoing cardiac repairs are surviving more frequently. Our objectives were to 1) estimate the prevalence of chronic kidney disease (CKD) and hypertension 6 years after neonatal congenital heart surgery and 2) determine if cardiac surgery-associated acute kidney injury (CS-AKI) is associated with these outcomes. Methods: Two-center prospective, longitudinal single-visit cohort study including children with congenital heart disease surgery as neonates between January 2005 and December 2012. CKD (estimated glomerular filtration rate < 90 mL/min/1.73m2 or albumin/creatinine ≥3 mg/mmol) and hypertension (systolic or diastolic blood pressure ≥ 95th percentile for age, sex, and height) prevalence 6 years after surgery was estimated. The association of CS-AKI (Kidney Disease: Improving Global Outcomes definition) with CKD and hypertension was determined using multiple regression. Results: Fifty-eight children with median follow-up of 6 years were evaluated. CS-AKI occurred in 58%. CKD and hypertension prevalence were 17% and 30%, respectively; an additional 15% were classified as having elevated blood pressure. CS-AKI was not associated with CKD or hypertension. Classification as cyanotic postoperatively was the only independent predictor of CKD. Postoperative days in hospital predicted hypertension at follow-up. Conclusions: The prevalence of CKD and hypertension is high in children having neonatal congenital heart surgery. This is important; early identification of CKD and hypertension can improve outcomes. These children should be systematically followed for the evolution of these negative outcomes. CS-AKI defined by current standards may not be a useful clinical tool to decide who needs follow-up and who does not. [ABSTRACT FROM AUTHOR]
- Subjects :
- *HYPERTENSION risk factors
*HYPERTENSION epidemiology
*ACUTE kidney failure
*BLOOD pressure
*CHRONIC kidney failure
*CONGENITAL heart disease
*CYANOSIS
*GLOMERULAR filtration rate
*CARDIAC surgery
*LONGITUDINAL method
*MEDICAL records
*PATIENTS
*RISK assessment
*SURGERY
*MULTIPLE regression analysis
*RETROSPECTIVE studies
*DESCRIPTIVE statistics
*ACQUISITION of data methodology
*DISEASE risk factors
*CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 0931041X
- Volume :
- 35
- Issue :
- 11
- Database :
- Academic Search Index
- Journal :
- Pediatric Nephrology
- Publication Type :
- Academic Journal
- Accession number :
- 146054505
- Full Text :
- https://doi.org/10.1007/s00467-020-04621-4