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Clinical and Pathophysiological Determinants of Cardiac Surgery–Associated Acute Kidney Injury in Young Children: The Role of Preoperative and Intraoperative Factors

Ismailov Saydimurad Ibragimovich
State Institution "Republican Specialized Scientific and Practical Medical Center of Surgery named after Academician V.Vakhidov", Tashkent, Uzbekistan Tashkent State Medical University, Tashkent, Uzbekistan
Khaydarov Alisher Erkinovich
State Institution "Republican Specialized Scientific and Practical Medical Center of Surgery named after Academician V.Vakhidov", Tashkent, Uzbekistan Tashkent State Medical University, Tashkent, Uzbekistan
Sobirov Doniyor Murodjonovich
State Institution "Republican Specialized Scientific and Practical Medical Center of Surgery named after Academician V.Vakhidov", Tashkent, Uzbekistan
Khalikulov Khusan Gazixanovich
State Institution "Republican Specialized Scientific and Practical Medical Center of Surgery named after Academician V.Vakhidov", Tashkent, Uzbekistan Tashkent State Medical University, Tashkent, Uzbekistan
Irmatov Sarvar Hikmatillaevich
State Institution "Republican Specialized Scientific and Practical Medical Center of Surgery named after Academician V.Vakhidov", Tashkent, Uzbekistan
Mirzaev Khondamir Alisher ugli
State Institution "Republican Specialized Scientific and Practical Medical Center of Surgery named after Academician V.Vakhidov", Tashkent, Uzbekistan Tashkent State Medical University, Tashkent, Uzbekistan
DOI Crossref DOI 10.37547/tajmspr/Volume08Issue04-16
tajmspr 2026
VOL. 8 / NO. 04 APRIL
FULL TEXT PP. 106-113
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VOLUME 8
ISSUE 04
YEAR 2026
PAGES 106-113
RESEARCH OVERVIEW

Abstract

Cardiac surgery–associated acute kidney injury (CSA-AKI) in young children is a common and clinically significant complication following surgical correction of congenital heart defects, developing as a result of the combined impact of baseline renal vulnerability and intraoperative perfusion stress.

Objective. To identify clinical and pathophysiological risk factors for CSA-AKI and to determine independent predictors of its development in young children. The study included 585 children under 3 years of age who underwent cardiac surgery with cardiopulmonary bypass. CSA-AKI was diagnosed according to KDIGO criteria. Preoperative and intraoperative factors were analyzed using univariate and multivariate statistical methods. CSA-AKI developed in 224 patients (38.3%). At the preoperative stage, significant risk factors included heart failure, hypoxemia, low body weight, and high complexity of congenital heart defects. In the intraoperative period, the risk of CSA-AKI was significantly associated with cardiopulmonary bypass duration >90 minutes, hyperlactatemia, hematocrit <25%, and reduced urine output. Multivariate analysis identified elevated lactate levels, prolonged perfusion duration, hemodilution, and early renal functional response as independent predictors. CSA-AKI in young children is determined by a combination of preoperative and intraoperative factors reflecting impaired systemic perfusion and oxygen delivery. Early risk stratification and targeted control of modifiable perfusion parameters are essential for prevention.

RESEARCH TOPICS

Keywords

Congenital heart defects cardiopulmonary bypass acute kidney injury

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References

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