title: Intra- and postoperative adverse events in children with nephrotic syndrome requiring surgery under general anesthesia.
abstract: BACKGROUND
  There are few data regarding perioperative adverse events in children with nephrotic syndrome.
  
  
  OBJECTIVE
  The aim of this study was to describe the nature and frequency of perioperative adverse events in children with nephrotic syndrome.
  
  
  METHODS
  This is a retrospective study from a large university pediatric hospital. All procedures under general anesthesia in children with nephrotic syndrome between January 1995 and May 2007 were included, with the exception of renal transplantation. Data were collected on demographics, etiology of nephrotic syndrome and related treatments, surgical procedures and anesthetic techniques, and pre- and postoperative treatments. Adverse events occurring during the intraoperative period and up to the fifth postoperative day were recorded.
  
  
  RESULTS
  Data on eight patients who underwent 24 surgical or interventional procedures under general anesthesia over the study period were reviewed. Three patients had steroid-resistant nephrotic syndrome and five patients had congenital or infantile nephrotic syndrome. Five patients had progressed to end-stage renal failure requiring dialysis. General anesthesia was performed for: nephrectomy (n = 9), central venous catheter insertion (n = 8), peritoneal dialysis catheter insertion (n = 5), and emergency surgery in two cases (acute intestinal intussusception and hemodialysis catheter insertion). Three patients were receiving aspirin and one anticoagulant therapy. No postoperative thrombosis or infections, bleeding, peripheral edema or ascites, and increase in kalemia were noted. There was no significant postoperative increase in median serum creatinine level.
  
  
  CONCLUSIONS
  Surgical procedures were seldom associated with the occurrence of perioperative adverse events. However, larger studies are needed to confirm these results.
authors.affiliation: Department of Anesthesiology and Critical Care, Necker - Enfants Malades Hospital, AP-HP, University Paris Descartes, PARIS Cedex, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Greff
authors.forename: Judith
authors.initials: J
authors.lastname: Faivre
authors.forename: Pierre A
authors.initials: PA
authors.lastname: Carli
authors.forename: Patrick
authors.initials: P
authors.lastname: Niaudet
authors.forename: Gilles A
authors.initials: GA
authors.lastname: Orliaguet
mesh_terms: D017668:Age of Onset; D000768:Anesthesia, General / Q000009:adverse effects*; D000925:Anticoagulants / Q000627:therapeutic use; D001424:Bacterial Infections / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D005260:Female; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications / Q000453:epidemiology*; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000706:statistics & numerical data; D008297:Male; D009392:Nephrectomy; D009404:Nephrotic Syndrome / Q000150:complications*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011183:Postoperative Complications / Q000453:epidemiology*; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D012189:Retrospective Studies; D013923:Thromboembolism / Q000453:epidemiology
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors