Early Peritoneal dialysis after repair of congenital heart disease in children / 中华胸心血管外科杂志

ABSTRACT

Objective The mortality rate of the children after surgical repair of congenital heart disease associated with acute renal injure has been reported to be 30％-79％.Peritoneal dialysis is the common treatment method for those patients,but the optimal time to initiate peritoneal dialysis is still controversial.The aim of this study was to investigate the clinic outcome of early peritoneal dialysis to the children following cardiac surgery.Methods We performed a retrospective chart of children following cardiac surgery from January 2008 to December 2009.The total number was 4561,62 of them were performed PD treatment.Data on the PD treatment children were collected from pre-operation to hospital discharge.Early peritoneal dialysis group was defintes as PD initiated at operation room or the interval between the end of operation to starting peritoneal dialysis less than 3hrs.the others were traditional PD group.Results The whole PD treatment rate was 1.36％,15 patients died.The mortality were 10.71％ (3/28) in early PD and 35.29％ (12/34) in conditional PD group respectively (P =0.036).2 patients were met RIFLE(risk,injury,failure,loss,and end-stage renal disease,RIFLE)classification as failure grade in early PD group while 10 patients in traditional PD group (P =0.001).After PD treatment 24hrs,the Vasoactive-Inotrope Scores and serum creatinine values were much lower in the early PD group children than those in the traditional PD group[(19.00 ±2.39) vs(37.00±5.22),P=0.002;(50.51 ±21.84) vs(130.13±76.09),P=0.001)].Conclusion This study shows that early PD can prevent the children after congenital heart surgery to develop AKI,and reduce the severity of the clinic status.Early intervention with PD is associated with low mortality.