Acute nierinsufficiëntie en nierfunctievervangende therapie na cardiopulmonale bypasschirurgie bij kinderen

In a retrospective study renal function and renal replacement therapy after cardiopulmonary bypass surgery in children was investigated at the Department of Cardiothoracic Surgery at the Leiden University Medical Center and Academic Medical Center of Amsterdam. Patient characteristics (sex, age, diagnosis), operation type and death were listed. Serum creatinine level before and peak values after cardiopulmonary bypass surgery were used for assessment of renal function. For the children on renal replacement therapy, indication, efficacy, and complications were recorded. In a 5-year period (1994-1999), 1075 children had cardiopulmonary bypass surgery. Of the patients 180 (17%) developed acute renal insufficiency. Twenty-five (2,3%) patients required renal replacement therapy. Peritoneal dialysis is a safe and effective treatment for children post cardiopulmonary bypass surgery. However, 15 (60%) of the 25 children on renal replacement therapy died of non-renal causes. In 9 of the 10 surviving children renal function was normal at the time of discharge. In conclusion, acute renal insufficiency is a frequent complication after open-heart surgery, although renal replacement therapy was infrequently necessary. Peritoneal dialysis is a safe and effective therapeutic measure for children after cardiopulmonary bypass surgery.