Fatma Ukil IŞILDAK, Yasemin YAVUZ, Ömer Faruk ŞAVLUK, Ufuk USLU, Nihat ÇİNE

Preoperatif Albumin Düzeyi, Pediatrik Kalp Cerrahisi Sonrası Akut Böbrek Hasarı ile İlişkili Değildir: Bir Retrospektif Kohort Çalışması

Giriş: Bu çalışmanın amacı, konjenital kalp hastalığı nedeniyle açık kalp cerrahisi geçiren pediatrik hastalarda akut böbrek hasarı (ABH) gelişiminin preoperatif albumin/prealbumin düzeyleri ve diğer klinik özellikler ile ilişkili olup olmadığını değerlendirmektir. Hastalar ve Yöntem: Bu retrospektif kohorta, 1 Ocak 2018-31 Aralık 2020 tarihleri arasında İstanbul Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesinde konjenital kalp hastalığı tanısıyla açık kalp cerrahisi (tam düzeltme ameliyatı) geçiren 1-60 ay arası hastalar, geriye dönük olarak dahil edilmiştir (n= 100). Hastaların demografik özellikleri, tanıları, cerrahi özellikleri ve laboratuvar bulguları kaydedildi ve analiz edildi. Bulgular: Ortalama yaş 13.63 ± 12.05 (dağılım 1.5-60) aydır. eGFR, olguların %13’ünde %50’den fazla azalmıştır. Preoperatif döneme göre üre (24 ve 48. saat) ve kreatinin düzeylerinin anlamlı olarak arttığı (her biri için p< 0.001) ve postoperatif dönemde eGFR’nin anlamlı olarak düştüğü (p< 0.001) saptanmıştır. EGFR değeri için oluşturulan regresyon modelinde, daha uzun aortik çapraz klemp süresinin (ACCT) eGFR’de daha büyük bir azalma ile ilişkili olduğu görülmüştür (p= 0.046). Modelde yer alan diğer değişkenler, yaş (p= 0.128), cinsiyet (p= 0.358), RACHS (p= 0.865), beden kitle indeksi (p= 0.862), prealbumin (p= 0.313), albumin (p= 0.806) ve kardiyopulmoner baypas süresi (p= 0.921) anlamlı bulunmamıştır. Sonuç: Konjenital kalp hastalığı nedeniyle kalp cerrahisi geçiren hastalarda eGFR ile preoperatif albümin/ prealbumin düzeyleri arasında ilişki bulunmazken, daha uzun süre AKT’nin azalmış eGFR ile ilişkili olduğu bulunmuştur

Preoperative Albumin Level is Not Associated with Acute Kidney Injury After Pediatric Cardiac Surgery: A Retrospective Cohort

Introduction: This study aimed to evaluate whether the development of acute kidney injury (AKI) was associated with preoperative albumin/prealbumin levels and other clinical features in pediatric patients who underwent open-heart surgery for congenital heart disease. Patients and Methods: In this retrospective cohort, patients aged between 1-60 months who underwent openheart surgery (complete correction surgery) with a diagnosis of congenital heart disease at the Kartal Kosuyolu High Specialization Training and Research Hospital, between January 1, 2018-December 31, 2020, were retrospectively included (n= 100). Patient demographics, diagnoses, surgical characteristics, and laboratory findings were recorded and analyzed. Results: Mean age was 13.63 ± 12.05 (range 1.5-60) months. eGFR was decreased by more than 50% in 13% of the cases. Compared to the preoperative period, it was found that urea (24th and 48th hour) and creatinine levels increased significantly (p< 0.001, for each), and eGFR decreased significantly in the postoperative period (p< 0.001). Linear regression for eGFR value revealed that longer aortic cross-clamp time (ACCT) was associated with a greater decrease in eGFR (p= 0.046). Other variables included in the model, age (p= 0.128), gender (p= 0.358), RACHS (p= 0.865), body mass index (p= 0.862), prealbumin (p= 0.313), albumin (p= 0.806) and duration of cardiopulmonary bypass (p= 0.921) were found to be non-significant. Conclusion: While there was no relationship between eGFR and preoperative albumin/prealbumin levels in patients who underwent cardiac surgery due to congenital heart disease, longer ACCT was found to be associated with decreased eGFR

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi