Table 1.

Cohort description among children by severe AKI status

Developed Severe AKI
All (n = 311)Yes (n = 53)No (n = 258)P
Age at the time of surgery, mean (SD)3.8 (4.5)2.7 (4.3)4.0 (4.5)0.02
Age at the time of surgery, n (%)<0.01
    1 month to 2 years158 (51%)37 (70%)121 (47%)
    2 to 13 years134 (43%)13 (25%)121 (47%)
    13 to 18 years19 (6%)3 (5%)16 (6%)
Male gender, n (%)171 (55%)27 (51%)144 (56%)0.5
Caucasian race, n (%)254 (82%)42 (79%)212 (82%)0.6
Type of surgery, n (%)0.3
    elective283 (91%)46 (87%)237 (92%)
    urgent28 (9%)7 (13%)21 (8%)
Renal function
    preoperative eGFR (ml/min per 1.73 m2), mean (SD)90 (26)97 (28)89 (25)0.04
    preoperative eGFR (percentile), mean (SD)a53 (34)69 (32)49 (33)<0.0001
Preoperative medications
    ACE inhibitors, n (%)54 (18%)12 (23%)42 (16%)0.3
    aspirin, n (%)36 (12%)7 (13%)29 (11%)0.7
    beta blockers, n (%)11 (4%)3 (6%)8 (3%)0.4
Operative characteristics
    RACHS-1 score, mean (SD)b2.4 (0.7)2.6 (0.7)2.4 (0.7)0.3
    RACHS-1 score, n (%)<0.0001
        118 (6%)0 (0%)18 (7%)
        2153 (50%)30 (57%)123 (48%)
        3126 (41%)16 (30%)110 (43%)
        412 (4%)7 (13%)5 (2%)
        Not categorized202
    CPB use, n (%)307 (99%)52 (98%)255 (99%)0.5
    CPB time (min), mean (SD)107 (62)157 (90)97 (50)<0.0001
    Cross-clamp time (min), mean (SD)48 (46)71 (57)43 (41)<0.001
Outcomes
    length of ICU stay (days), mean (SD)4.1 (6.3)9.1 (10.9)3.2 (4.3)<0.0001
        median (IQR)2 (1, 4)5 (3, 8)2 (1, 3)
    length of hospital stay (days), mean (SD)8.5 (10.8)17.3 (19.2)6.8 (7.0)<0.0001
        median (IQR)5 (4, 8.5)9 (6, 16)5 (3, 7)
    dialysis or mortality, n (%)10 (3%)8 (15%)2 (1%)<0.0001
    dialysis, n (%)5 (2%)5 (9%)0 (0%)<0.0001
    mortality, n (%)6 (2%)4 (8%)2 (1%)0.0087
  • Severe AKI is defined as the receipt of dialysis or a doubling of serum creatinine during hospitalization. ICU, intensive care unit; ACE, angiotensin-converting enzyme.

  • aPercentile eGFR was calculated by quantile regression based on published normal renal function measured by nuclear medicine scan GFR in 651 children.31

  • bThe RACHS-1 consensus-based score system categorizes the complexity of surgery. Uncategorizable RACHS-1 scores were not included in the continuous summary of RACHS scores.