title: Acute Kidney Injury and Fluid Overload in Neonates Following Surgery for Congenital Heart Disease.
abstract: BACKGROUND
  Acute kidney injury (AKI) and fluid overload have been shown to increase morbidity and mortality. The reported incidence of AKI in pediatric patients following surgery for congenital heart disease is between 15% and 59%. Limited data exist looking at risk factors and outcomes of AKI or fluid overload in neonates undergoing surgery for congenital heart disease.
  
  
  METHODS
  Neonates aged 6 to 29 days who underwent surgery for congenital heart disease and who were without preoperative kidney disease were included in the study. The AKI was determined utilizing the Acute Kidney Injury Network criteria.
  
  
  RESULTS
  Ninety-five neonates were included in the study. The incidence of neonatal AKI was 45% (n = 43), of which 86% had stage 1 AKI. Risk factors for AKI included cardiopulmonary bypass time, selective cerebral perfusion, preoperative aminoglycoside use, small kidneys by renal ultrasound, and risk adjustment for congenital heart surgery category. There were eight mortalities (five from stage 1 AKI group, three from stage 2, and zero from stage 3). Fluid overload and AKI both increased hospital length of stay and postoperative ventilator days.
  
  
  CONCLUSIONS
  To avoid increased risk of morbidity and possibly mortality, every attempt should be made to identify and intervene on those risk factors, which may be modifiable or identifiable preoperatively, such as small kidneys by renal ultrasound.
authors.affiliation: Pediatric Cardiac Intensive Care, The Heart Center at Arnold Palmer Hospital for Children, University of Central Florida College of Medicine, Orlando, FL, USA kurt.piggott@orlandohealth.com.
authors.forename: Kurt D
authors.initials: KD
authors.lastname: Piggott
authors.affiliation: University of Central Florida, Orlando, FL, USA.
authors.forename: Meshal
authors.initials: M
authors.lastname: Soni
authors.affiliation: Pediatric Cardiothoracic Surgery, The Heart Center at Arnold Palmer Hospital for Children, University of Central Florida College of Medicine, Orlando, FL, USA.
authors.forename: William M
authors.initials: WM
authors.lastname: Decampli
authors.affiliation: Arnold Palmer Hospital for Children Hewell Kids Kidney Center, University of Central Florida College of Medicine, Orlando, FL, USA.
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Ramirez
authors.affiliation: Pediatric Cardiac Intensive Care, The Heart Center at Arnold Palmer Hospital for Children, Orlando, FL, USA.
authors.forename: Dianna
authors.initials: D
authors.lastname: Holbein
authors.affiliation: Pediatric Cardiac Intensive Care, The Heart Center at Arnold Palmer Hospital for Children, University of Central Florida College of Medicine, Orlando, FL, USA.
authors.forename: Harun
authors.initials: H
authors.lastname: Fakioglu
authors.affiliation: Pediatric Cardiac Intensive Care, The Heart Center at Arnold Palmer Hospital for Children, Orlando, FL, USA.
authors.forename: Carlos J
authors.initials: CJ
authors.lastname: Blanco
authors.affiliation: Pediatric Cardiothoracic Surgery, The Heart Center at Arnold Palmer Hospital for Children, University of Central Florida College of Medicine, Orlando, FL, USA.
authors.forename: Kamal K
authors.initials: KK
authors.lastname: Pourmoghadam
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology*; D042241:Early Diagnosis; D004812:Epidemiologic Methods; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014883:Water-Electrolyte Imbalance / Q000175:diagnosis / Q000209:etiology*
keywords: acute kidney injury; congenital heart disease; fluid overload; heart surgery; neonate; pediatric