Peritoneal dialysis in acute kidney injury after pediatric cardiac surgery: A single-center experience and perspectives at the Corporate Fund University Medical Center “Heart Center” in Kazakhstan
DOI:
https://doi.org/10.37800/RM.2.2026.677Keywords:
acute kidney injury , congenital heart defects , peritoneal dialysis , pediatric cardiac surgery, neonatal intensive care, postoperative complications, renal replacement therapyAbstract
Relevance: Acute kidney injury associated with cardiac surgery remains a frequent and serious complication in children, especially among infants with congenital heart defects. Peritoneal dialysis is increasingly used as a method of renal replacement therapy in this population. However, clinical predictors and laboratory markers associated with an unfavorable postoperative course in this high-risk population have not been adequately studied. Clarifying these risk factors is necessary to optimize early management strategies and improve outcomes.
The study aimed to assess clinical and laboratory characteristics and risk factors for an unfavorable postoperative course in infants who underwent surgical correction of congenital heart defects and were subsequently placed on peritoneal dialysis.
Materials and Methods: A retrospective single-center study was conducted, including 122 patients under 3 years of age who underwent cardiac surgery with cardiopulmonary bypass between 2017 and 2023. The study group (n = 72) received PD, while the control group (n = 50) did not. The incidence of complications, duration of mechanical ventilation, and laboratory parameters were analyzed. Pearson’s χ² test, Fisher’s exact test, and the Mann-Whitney U test were used for statistical analysis. Results were considered statistically significant at p ≤ 0.05.
Results: The incidence of hemorrhagic complications in the PD group was 93%, compared to 14% in the control group (p < 0.001). The duration of mechanical ventilation was also significantly longer in the PD group (mean rank 82.15 vs. 31.76; p < 0.001). The incidence of sepsis in the PD group was 24%, versus 10% in the control group (p = 0.055).
Conclusion: Despite the higher complication rate, PD remains an important management option for children with acute kidney injury after cardiac surgery. Patients in the PD group had a notably more severe clinical condition. Further prospective studies are needed to more accurately assess the benefits and risks of PD, accounting for patients’ disease severity.
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