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Peritoneal dialysis during congenital heart surgery admissions: insights from a large database

Published online by Cambridge University Press:  05 March 2020

Rohit S. Loomba Open the ORCID record for Rohit S. Loomba [Opens in a new window] ,
Enrique G. Villarreal Open the ORCID record for Enrique G. Villarreal [Opens in a new window] ,
Ronald A. Bronicki  and
Saul Flores
Rohit S. Loomba
Affiliation:
Cardiology, Pediatrics, Advocate Children’s Hospital, Oak Lawn, IL, USA
Enrique G. Villarreal*
Affiliation:
Critical Care and Cardiology, Pediatrics, Texas Children’s Hospital/Baylor College of Medicine, Houston, TX, USA Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Mexico
Ronald A. Bronicki
Affiliation:
Critical Care and Cardiology, Pediatrics, Texas Children’s Hospital/Baylor College of Medicine, Houston, TX, USA
Saul Flores
Affiliation:
Critical Care and Cardiology, Pediatrics, Texas Children’s Hospital/Baylor College of Medicine, Houston, TX, USA
*
Author for correspondence: E. G. Villarreal, MD, Cardiac Intensive Care Unit, Section of Critical Care and Cardiology, Research Scholar, Texas Children’s Hospital/Baylor College of Medicine, 6651 S. Main St, MCE 1420, Suite E. 1460.31A., Houston, TX77030, USA. Tel: +1 312 282 6935; Fax: +1 832 825 2969. E-mail: quique_villarreal93@hotmail.com; noyola@bcm.edu
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Abstract

Background:

The management of fluid overload after congenital heart surgery has been limited to diuretics, fluid restriction, and dialysis. This study was conducted to determine the association between peritoneal dialysis and important clinical outcomes in children undergoing congenital heart surgery.

Methods:

A retrospective review was conducted to identify patients under 18 years of age who underwent congenital heart surgery. The data were obtained over a 16-year period (1997–2012) from the Kids’ Inpatient Database. Data analysed consisted of demographics, diagnoses, type of congenital heart surgery, length of stay, cost of hospitalisation, and mortality. Logistic regression was performed to determine factors associated with peritoneal dialysis.

Results:

A total of 46,176 admissions after congenital heart surgery were included in the study. Of those, 181 (0.4%) utilised peritoneal dialysis. The mean age of the peritoneal dialysis group was 7.6 months compared to 39.6 months in those without peritoneal dialysis. The most common CHDs were atrial septal defect (37%), ventricular septal defect (32.6%), and hypoplastic left heart syndrome (18.8%). Univariate analyses demonstrated significantly greater length of stay, cost of admission, and mortality in those with peritoneal dialysis. Regression analyses demonstrated that peritoneal dialysis was independently associated with significant decrease in cost of admission (−$57,500) and significant increase in mortality (odds ratio 1.5).

Conclusions:

Peritoneal dialysis appears to be used in specific patient subsets and is independently associated with decreased cost of stay, although it is associated with increased mortality. Further studies are needed to describe risks and benefit of peritoneal dialysis in this population.

Keywords

Paediatricskidneyrenal insufficiencyCHDperitoneal dialysis
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 4 , April 2020 , pp. 451 - 455
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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