Pediatric Postoperative Acute Kidney Injury After Noncardiac Surgery: A Systematic Review and Meta-Analysis.
Arash Emami, Ebba Sivertsson, Johan Westerbergh et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the incidence of postoperative acute kidney injury (AKI) in children undergoing noncardiac surgery, analyzing data from 27 studies with 21,908 patients. The overall incidence of AKI was found to be 22.3% after neonatal surgery and 30.1% after pediatric liver transplantation, highlighting significant variability and low certainty in the evidence.
Key findings
- AKI incidence was 22.3% after neonatal surgery (95% CI, 11.2-39.3).
- In pediatric liver transplantation, AKI incidence was 30.1% (95% CI, 21.4-40.6).
- AKI incidence increased from 2.4% in ASA class 1-2 to 18.9% in ASA 4-5 (p < 0.001).
- Incidence decreased from 9.8% at 0-2 years to 4.0% at 12-18 years (p < 0.001).
Why it matters
Understanding the incidence of postoperative AKI in pediatric populations is crucial for risk assessment and management strategies. The findings underscore the need for heightened vigilance in high-risk groups, particularly neonates and those undergoing liver transplantation.
What to keep in mind
The study faced considerable heterogeneity and likely overrepresentation of high-risk populations, limiting the interpretability of the pooled incidence estimates.