Observational studyPediatric nephrology (Berlin, Germany)2018
Nephrotoxin exposure and acute kidney injury in critically ill children undergoing congenital cardiac surgery.
Observational study in Pediatric nephrology (Berlin, Germany), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 25 citations in OpenAlex.
- Risk of Acute Kidney Injury Associated With Nephrotoxic Burden in Hospitalized Patients: A Scoping Review.Clinical pharmacology and therapeutics · 2026Article
- Kidney Transplantation in Congenital Heart Disease Patients: What Are the Outcomes?Pediatric transplantation · 2025Article
- Framework for Kidney Health Follow-Up Among Neonates With Critical Cardiac Disease: A Report From the Neonatal Kidney Health Consensus Workshop.Journal of the American Heart Association · 2025Review
- Association between postoperative ibuprofen exposure and acute kidney injury after pediatric cardiac surgery.Renal failure · 2024Article
- Ketorolac Dosing and Outcomes in Neonates Following Congenital Heart Surgery: A Retrospective Analysis.Critical care explorations · 2024Article
- Epidemiology of acute kidney injury in children: a report from the 26th Acute Disease Quality Initiative (ADQI) consensus conference.Pediatric nephrology (Berlin, Germany) · 2024Article
- Case report: Challenging kidney transplantation in an adolescent patient with tetralogy of Fallot.Frontiers in medicine · 2024Article
- Review
- Consensus-Based Recommendations on Priority Activities to Address Acute Kidney Injury in Children: A Modified Delphi Consensus Statement.JAMA network open · 2022Article
- Kidney disease and congenital heart disease: Partnership for life.Frontiers in physiology · 2022Review
- Article
- Association of Ibuprofen Prescription With Acute Kidney Injury Among Hospitalized Children in China.JAMA network open · 2021Article
- Article
- Nephrotoxins and nephrotoxic acute kidney injury.Pediatric nephrology (Berlin, Germany) · 2020Review
- Cardiopulmonary Bypass and AKI: AKI Is Bad, So Let's Get Beyond the Diagnosis.Frontiers in pediatrics · 2019Review
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThough acute kidney injury (AKI) is often multifactorial, investigators are now emphasizing the specific contribution of nephrotoxins. This study examines the epidemiology of nephrotoxin exposure and nephrotoxin-associated AKI among children undergoing congenital heart surgery (CHS).
methodsThis is a retrospective cohort study of children admitted following CHS between June 1, 2014, and September 30, 2014. Nephrotoxins were defined according to the Nephrotoxic Injury Negated by Just-in-time-Action (NINJA) collaborative; high nephrotoxin exposure was defined as receipt of ≥ 3 nephrotoxins concurrently. AKI was diagnosed according to KDIGO creatinine criteria. Severe AKI was defined as KDIGO stage ≥ 2. Poisson models were used to compute adjusted relative risk (aRR) of high nephrotoxin exposure for AKI.
resultsOne hundred fifty-four children (median age 20.4 months, IQR 2.3-59.5) were included. One hundred thirty-one (85.1%) received at least one nephrotoxin; 32 (20.8%) received ≥ 3 nephrotoxins. The most commonly administered medications were ketorolac (n = 74, 48.1%), aspirin (n = 62, 40.3%), ibuprofen (n = 51, 33.1%), vancomycin (n = 39, 25.3%), piperacillin/tazobactam (n = 35, 22.7%), and enalapril (n = 14, 9.1%). AKI occurred more commonly in those exposed to ≥ 3 nephrotoxins (62.5 vs. 50.8%); this was not statistically significant after adjusting for confounders (aRR = 1.2, 95% CI 0.9-1.7). Severe AKI was similar between those with and without high nephrotoxin exposure (21.9 vs. 19.7%, p = 0.78).
conclusionsNephrotoxin use is common following pediatric CHS. While we found no association between high nephrotoxin exposure and AKI, this may be related to the multifactorial nature of AKI in this population. For many common nephrotoxins, less injurious agents exist and nephrotoxin exposure may represent a modifiable risk factor for AKI.
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