Abstract: FR-PO134
Predictors of Early Peritoneal Dialysis Start in Newborns and Young Infants Following Cardiac Surgery
Session Information
- AKI: Outcomes, RRT
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Author
- Onder, Ali Mirza, Nemours Children's Hospital Delaware, Wilmington, Delaware, United States
Background
This single center, retrospective cohort study was conducted to investigate the predictors of early peritoneal dialysis (PD) start initiation in newborns and young infants undergoing cardiac surgery.
Methods
There were fifty-seven newborns and young infants. All subjects received PD catheter after completion of the cardiopulmonary bypass (CPB). Worsening postoperative (post-op) positive fluid balance and oliguria (<1 ml/kg/hour) despite furosemide were the clinical indications to start early PD (PD +). Demographic, clinical and laboratory data were collected from the pre-operative, intra-operative and immediately post-operative periods.
Results
Baseline demographic data were indifferent except that PD + group had more newborns. Preoperative serum creatinine was higher for PD + group (p= 0.025). PD + group had longer CPB time (p=0.044), longer aorta cross-clamp time (p=0.044) and less urine output during early post-op 24 hours (p= 0.008). In the univariate logistic regression model, pre-op serum creatinine was significantly associated with higher odds of being in PD+ (p= 0.021) and post-op systolic BP (p=0.018) and post-op MAP (p=0.001) were significantly associated with reduced odds of being in PD + (p= 0.018 and p= 0.001, respectively). Post-op MAP showed a statistically significant association (aOR= 0.89, 95% CI [0.81, 0.96], p=0.004) with PD + in multivariate analysis after adjusting for age at surgery.
Conclusion
: In our single center cohort, pre-op serum creatinine, post-op systolic BP and MAP were demonstrated statistically significant association with PD +. This finding may help to better risk stratify newborns and young infants for early PD start following cardiac surgery.