Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Acute kidney injury (AKI) is a serious postoperative complication after cardiac surgery in children and is a major contributor to patient outcome. This study aims to identify the incidence of AKI in children undergoing cardiac surgery and the role of Interleukin 18 (IL-18) and Kidney Injury Molecule 1 (KIM-1) in diagnosis of AKI in comparison to creatinine. Material and methods: 44 children who underwent open heart surgery (on cardiopulmonary bypass) for congenital heart disease. Patients were assessed for AKI diagnosis according the KDIGO criteria, urinary IL-18 and KIM-1 were measured in addition to the UOP, GFR, length of stay and outcome and the effect of AKI on these parameters. Results: twenty three percent of the patient developed AKI, there were no statistical correlation between AKI and the factors (Age, gender, CPB and RACHS complexity score). Eight of our patients needed peritoneal dialysis (PD), seven of them developed AKI and the 8th patient didn{u2019}t develop due to the early initiation of PD. There was strong correlation between the development of AKI and the Length of stay in ICU. Both IL-18 and KIM-1 were higher in the patients who didn{u2019}t develop AKI than the patients who developed AKI. Conclusion: AKI is common among children undergoing open heart surgery. Creatinine is the gold standard biomarker in diagnosis of AKI. Early initiation of PD could prevent the development of AKI

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