Acute renal insufficiency and renal replacement therapy after pediatric cardiopulmonary bypass surgery

The aim of the study was to investigate renal function and renal replacemen t therapy after cardiopulmonary bypass surgery in children. Patient charact eristics (sex, age, diagnosis), operation type, and death were listed. The study was performed retrospectively using serum creatinine level before, an d peak values after, cardiopulmonary bypass surgery for assessment of renal function. Of the children on renal replacement therapy, indication, effica cy, and complications were recorded. In a 5-year period, 1075 children had cardiopulmonary bypass surgery at the Department of Cardiothoracic Surgery at Leiden University Medical Center and Academic Medical Center of Amsterda m. One-hundred eighty (17%) patients developed acute renal insufficiency. T wenty-five (2.3%) patients required renal replacement therapy. Peritoneal d ialysis is a safe and effective treatment for children after cardiopulmonar y bypass surgery. However, 15 (60%) of 25 children on renal replacement the rapy died of nonrenal causes. In 9 out of 10 surviving children, renal func tion was normal at time of discharge from hospital. Acute renal insufficien cy is a frequent complication after open-heart surgery, although renal repl acement therapy was infrequently necessary. Peritoneal dialysis is a safe a nd effective therapeutic measure for children after cardiac bypass surgery.