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Postoperative Acute Kidney Injury in Young Adults With Congenital Heart Disease
Fuhrman and colleagues investigated the occurrence of acute kidney injury (AKI) in young adults with congenital heart disease undergoing a surgical procedure, a group of patients that is increasing in number. They retrospectively analyzed data for 699 patients between 18 and 40 years of age who were admitted to a children’s hospital's cardiac intensive care unit over an 11 year time period. AKI occurred in 13.2% of these patients. Suspected sepsis, exposure to calcineurin inhibitors, vancomycin, and piperacillin-tazobactam increased the odds of injury, even after controlling for several factors including repeat cardiopulmonary bypass.
The authors conclude that postoperative AKI is common in young adults with congenital heart disease and is associated with adverse outcomes. They also suggest that care be taken in the use of potentially nephrotoxic medications.