title: [Acute kidney injury after pediatric cardiac surgery: risk factors and outcomes. Proposal for a predictive model].
abstract: OBJECTIVE
  To characterize the epidemiology and risk factors for acute kidney injury (AKI) after pediatric cardiac surgery in our center, to determine its association with poor short-term outcomes, and to develop a logistic regression model that will predict the risk of AKI for the study population.
  
  
  METHODS
  This single-center, retrospective study included consecutive pediatric patients with congenital heart disease who underwent cardiac surgery between January 2010 and December 2012. Exclusion criteria were a history of renal disease, dialysis or renal transplantation.
  
  
  RESULTS
  Of the 325 patients included, median age three years (1 day-18 years), AKI occurred in 40 (12.3%) on the first postoperative day. Overall mortality was 13 (4%), nine of whom were in the AKI group. AKI was significantly associated with length of intensive care unit stay, length of mechanical ventilation and in-hospital death (p<0.01). Patients' age and postoperative serum creatinine, blood urea nitrogen and lactate levels were included in the logistic regression model as predictor variables. The model accurately predicted AKI in this population, with a maximum combined sensitivity of 82.1% and specificity of 75.4%.
  
  
  CONCLUSIONS
  AKI is common and is associated with poor short-term outcomes in this setting. Younger age and higher postoperative serum creatinine, blood urea nitrogen and lactate levels were powerful predictors of renal injury in this population. The proposed model could be a useful tool for risk stratification of these patients.
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa, Portugal. Electronic address: barbaracardoso.ba@gmail.com.
authors.forename: Bárbara
authors.initials: B
authors.lastname: Cardoso
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa, Portugal.
authors.forename: Sérgio
authors.initials: S
authors.lastname: Laranjo
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa, Portugal.
authors.forename: Inês
authors.initials: I
authors.lastname: Gomes
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Freitas
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa, Portugal.
authors.forename: Conceição
authors.initials: C
authors.lastname: Trigo
authors.affiliation: Serviço de Anestesiologia, Hospital de Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Fragata
authors.affiliation: Serviço de Cirurgia Cardiotorácica, Hospital de Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Fragata
authors.affiliation: Serviço de Cardiologia Pediátrica, Hospital Santa Marta - Centro Hospitalar de Lisboa Central, Lisboa, Portugal.
authors.forename: Fátima
authors.initials: F
authors.lastname: Pinto
mesh_terms: D058186:Acute Kidney Injury; D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006330:Heart Defects, Congenital; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Acute kidney injury; Cardiac surgery; Cardiopatias congénitas; Cirurgia cardíaca; Congenital heart disease; Insuficiência renal aguda