Renal Function in Children With Congenital Heart Disease After Cardiopulmonary Bypass



Saadaat N ; Abtahi S ; Maliki MH ; Samadieh F ; Najafi F
Source: Iranian Heart Journal Published:2025

Abstract

Background: Kidney dysfunction is a known complication in children with congenital heart disease (CHD). While numerous studies have explored risk factors for nephropathy in this population, research specifically comparing renal function before and after open-heart surgery remains limited. This study aimed to evaluate kidney function in children with CHD both before and after cardiopulmonary bypass and open-heart surgery. Methods: This prospective observational study included children with CHD, aged 1 month to 5 years, who underwent open-heart surgery. Demographic information and serum levels of creatinine, urea, albumin, and glomerular filtration rate (GFR) were collected at 24 hours pre-surgery and at 24, 48, and 72 hours, and 1 week post-surgery. Data analysis and comparisons were performed based on the type of CHD (cyanotic versus acyanotic). Findings: Twenty-six cyanotic and 40 acyanotic children with CHD, with a mean age of 16.34 ± 15.50 months, were included in the study. Serum levels of creatinine, urea, and albumin significantly increased 24 hours after the operation (P <0.05). GFR significantly decreased at 24 and 48 hours postoperatively (P <0.05). Moreover, 72 hours after the operation, creatinine levels were significantly higher in the cyanotic group than in the acyanotic group (P =0.007). At 24 hours (P =0.02) and 72 hours (P =0.05) postoperatively, higher mean urea levels were observed in the cyanotic group. Patients undergoing surgeries lasting over 60 minutes had higher serum urea levels than those with shorter surgical durations (P =0.05). Conclusions: These results suggest that renal function indices were altered during the first two days following open-heart surgery in children with CHD. (Iranian Heart Journal 2025; 26(4): 6-14). © 2025 Elsevier B.V., All rights reserved.