title: Continuous hemodiafiltration in children after cardiac surgery.
abstract: Acute renal failure (ARF) after congenital cardiac surgery remains a serious complication and leading cause of morbidity and mortality. Continuous hemodiafiltration (CHDF) is presently accepted for pediatric applications. We retrospectively evaluated the effects of CHDF against ARF after congenital cardiac surgery at our hospital. We analyzed data from seven patients aged 23 days to 9 years and weighing 1.7-22.4 kg requiring dialysis therapy using CHDF after congenital cardiac surgery between April 2002 and January 2009. One patient who died could not be weaned from extracorporeal membrane oxygenation support and another died of multiple organ failure. Renal function recovered to normal in the other five (71%) patients. Treatment by CHDF lasted from 14 to 680 h and net ultrafiltration was 3.5 ± 1.4 mL/kg/h. Serum creatinine and urea concentrations were, respectively, 2.3 ± 1.6 and 43.7 ± 17.0 mg/dL before, and 0.5 ± 0.2 and 13.5 ± 8.1 mg/dL, after CHDF (P < 0.05). Thrombocytopenia developed in all patients, and platelet concentrates (0.76 ± 0.7 mL/kg/h) were infused during CHDF. Hypotension developed after changing the CHDF set in one patient. We suggest that CHDF is an effective alternative strategy for treating renal dysfunction after congenital cardiac surgery.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Goto
authors.forename: Sanae
authors.initials: S
authors.lastname: Yamauchi
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Daitoku
authors.forename: Kozo
authors.initials: K
authors.lastname: Fukui
authors.forename: Ikou
authors.initials: I
authors.lastname: Fukuda
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000628:therapy*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D017583:Hemodiafiltration / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007223:Infant; D007677:Kidney Function Tests; D008297:Male; D012189:Retrospective Studies