SynthesisClinical journal of the American Society of Nephrology : CJASN2021
Strategies to Prevent Acute Kidney Injury after Pediatric Cardiac Surgery: A Network Meta-Analysis.
Synthesis in Clinical journal of the American Society of Nephrology : CJASN, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Biomarkers of acute kidney injury after pediatric cardiac surgery: a meta-analysis of diagnostic test accuracy.European journal of pediatrics · 2022Pooled it
- The incidence and risk factors associated with severe acute kidney injury and operative mortality in neonates following cardiac surgery: a single-center experience.Pediatric nephrology (Berlin, Germany) · 2026Article
- Urine Output Response to a Furosemide Infusion in Infants After Cardiopulmonary Bypass as a Predictor of Acute Kidney Injury.Pediatric cardiology · 2026Article
- Incidence and independent risk factors for postoperative delirium in ICU patients after cardiopulmonary bypass cardiac surgery: a retrospective cohort study.Frontiers in cardiovascular medicine · 2026Article
- Acute Effects of Aminophylline Effects on Hemodynamic Parameters and Fluid Balance in Pediatric Cardiac Intensive Care Patients: Machine Learning Insights Using High Fidelity Data.Pediatric cardiology · 2025Article
- Biomarker urinary neutrophil gelatinase-associated lipocalin as a predictor of acute kidney injury in neonates.Future science OA · 2025Article
- Risk of acute kidney injury following intravenous iodinated contrast exposure among pediatric population: a narrative review.Pediatric radiology · 2025Review
- Kidney Injury Following Cardiac Surgery: A Review of Our Current Understanding.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025Review
- Biomarker-based acute kidney injury sub-phenotypes refine risk assessment in children undergoing cardiac surgery.Pediatric nephrology (Berlin, Germany) · 2025Observational
- Development and Validation of a Nomogram for Predicting Acute Kidney Injury in Pediatric Patients Undergoing Cardiac Surgery.Pediatric cardiology · 2025Article
- Machine Learning Model-Based Prediction of In-Hospital Acute Kidney Injury Risk in Acute Aortic Dissection Patients.Reviews in cardiovascular medicine · 2025Article
- Association between postoperative ibuprofen exposure and acute kidney injury after pediatric cardiac surgery.Renal failure · 2024Article
- Fluid Overload and AKI After the Norwood Operation: The Correlation and Characterization of Routine Clinical Markers.Pediatric cardiology · 2024Article
- Article
- Acute Kidney Injury after High-Flow Regional Cerebral Perfusion in Neonatal and Infant Aortic Arch Repair.Interactive cardiovascular and thoracic surgery · 2022Article
- Persistent Markers of Kidney Injury in Children Who Developed Acute Kidney Injury After Pediatric Cardiac Surgery: A Prospective Cohort Study.Journal of the American Heart Association · 2022Article
Corrections and comments
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Authors and funding
12 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesAKI is a common complication after pediatric cardiac surgery and has been associated with higher morbidity and mortality. We aimed to compare the efficacy of available pharmacologic and nonpharmacologic strategies to prevent AKI after pediatric cardiac surgery. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: PubMed/MEDLINE, Embase, Cochrane Controlled Trials Register, and reference lists of relevant articles were searched for randomized controlled trials from inception until August 2020. Random effects traditional pairwise, Bayesian network meta-analyses, and trial sequential analyses were performed.
resultsTwenty randomized controlled trials including 2339 patients and 11 preventive strategies met the eligibility criteria. No overall significant differences were observed compared with control for corticosteroids, fenoldopam, hydroxyethyl starch, or remote ischemic preconditioning in traditional pairwise meta-analysis. In contrast, trial sequential analysis suggested a 80% relative risk reduction with dexmedetomidine and evidence of <57% relative risk reduction with remote ischemic preconditioning. Nonetheless, the network meta-analysis was unable to demonstrate any significant differences among the examined treatments, including also acetaminophen, aminophylline, levosimendan, milrinone, and normothermic cardiopulmonary bypass. Surface under the cumulative ranking curve probabilities showed that milrinone (76%) was most likely to result in the lowest risk of AKI, followed by dexmedetomidine (70%), levosimendan (70%), aminophylline (59%), normothermic cardiopulmonary bypass (57%), and remote ischemic preconditioning (55%), although all showing important overlap.
conclusionsCurrent evidence from randomized controlled trials does not support the efficacy of most strategies to prevent AKI in the pediatric population, apart from limited evidence for dexmedetomidine and remote ischemic preconditioning.
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