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Paucity of renal follow-up by school age after neonatal cardiac surgery

Published online by Cambridge University Press:  19 May 2020

Sara Rodriguez-Lopez ,
Louis Huynh ,
Kelly Benisty ,
Adrian Dancea ,
Daniel Garros ,
Erin Hessey ,
Ari Joffe ,
Andrew Mackie ,
Ana Palijan  and
Alex Paun
...Show all authors
Sara Rodriguez-Lopez
Affiliation:
Department of Pediatrics, Division of Nephrology, Stollery Children’s Hospital, University of Alberta, Edmonton, AB, Canada
Louis Huynh
Affiliation:
Faculty of Health Sciences, School of Medicine, Queen’s University, Kingston, ON, Canada
Kelly Benisty
Affiliation:
Faculty of Medicine, McGill University, Montreal, QC, Canada
Adrian Dancea
Affiliation:
Department of Pediatrics, Division of Cardiology, Montreal Children’s Hospital, McGill University Health Centre, Montreal, QC, Canada
Daniel Garros
Affiliation:
Department of Pediatrics, Division of Pediatric Critical Care, Stollery Children’s Hospital, University of Alberta, Edmonton, AB, Canada
Erin Hessey
Affiliation:
Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
Ari Joffe
Affiliation:
Department of Pediatrics, Division of Pediatric Critical Care, Stollery Children’s Hospital, University of Alberta, Edmonton, AB, Canada
Andrew Mackie
Affiliation:
Department of Pediatrics, Division of Cardiology, Stollery Children’s Hospital, University of Alberta, Edmonton, AB, Canada
Ana Palijan
Affiliation:
McGill University Health Centre Research Institute, McGill University Health Centre, Montreal, QC, Canada
Alex Paun
Affiliation:
McGill University Health Centre Research Institute, McGill University Health Centre, Montreal, QC, Canada
Michael Pizzi
Affiliation:
McGill University Health Centre Research Institute, McGill University Health Centre, Montreal, QC, Canada
Teodora Riglea
Affiliation:
McGill University Health Centre Research Institute, McGill University Health Centre, Montreal, QC, Canada
Michael Zappitelli*
Affiliation:
Department of Pediatrics, Division of Nephrology, Toronto Hospital for Sick Children, Toronto, ON, Canada
Catherine Morgan*
Affiliation:
Department of Pediatrics, Division of Nephrology, Stollery Children’s Hospital, University of Alberta, Edmonton, AB, Canada
*
Michael Zappitelli, MD, MSc, Toronto Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Room 6th floor 9708, Toronto, Ontario, Canada, M5G 0A4. Tel: +1 416 813 7654 extension 304077. E-mail: michael.zappitelli@sickkids.ca
Author for correspondence: Catherine Morgan, MD, MSc, Edmonton Clinic Health Academy, Room 4-555, 11405-87 Avenue, Edmonton, Alberta, Canada, T6G 1C9. Tel: +1 780 248 5560. E-mail:cmorgan@ualberta.ca
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Abstract

Introduction:

There are little data about renal follow-up of neonates after cardiovascular surgery and no guidelines for long-term renal follow-up. Our objectives were to assess renal function follow-up practice after neonatal cardiac surgery, evaluate factors that predict follow-up serum creatinine measurements including acute kidney injury following surgery, and evaluate the estimated glomerular filtration rate during follow-up using routinely collected laboratory values.

Methods:

Two-centre retrospective cohort study of children 5–7 years of age with a history of neonatal cardiac surgery. Univariable and multivariable analyses were performed to determine factors associated with post-discharge creatinine measurements. Glomerular filtration rate was estimated for each creatinine using a height-independent equation.

Results:

Seventeen of 55 children (30%) did not have any creatinine measured following discharge after surgery until the end of study follow-up, which occurred at a median time of 6 years after discharge. Of the 38 children who had the kidney function checked, 15 (40%) had all of their creatinine drawn only in the context of a hospitalisation or emergency department visit. Acute kidney injury following surgery did not predict the presence of follow-up creatinine measurements.

Conclusions:

A large proportion of neonates undergoing congenital heart repair did not have a follow-up creatinine measured in the first years following surgery. In those that did have a creatinine measured, there did not appear to be any identified pattern of follow-up. A follow-up system for children who are discharged from cardiac surgery is needed to identify children with or at risk of chronic kidney disease.

Keywords

Neonatecardiac surgeryfollow-upserum creatinine
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 6 , June 2020 , pp. 822 - 828
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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