Risk Factors Associated with Cardiorenal Syndrome Type I in Children with Congenital Aortic Arc Pathology

Amanzholova A. Morenko M. Baiko S. Nigmatullina N. Besbayeva G. Khamitova Z. Zhankorazova A. Koichubayeva D. Bekishev B. Mustapayeva N.
2025 Professionalnye Izdaniya

Pediatrics Eastern Europe
2025 #13 Issue 2 186 - 195 pp.

Introduction. Acute kidney injury (AKI) is one of the most serious postoperative complications in neonates undergoing surgical correction of congenital heart defects (CHD). Its development significantly worsens prognosis, increasing the incidence of complications and mortality. A particularly vulnerable group includes patients with congenital aortic arch pathology (CAP), who require complex interventions in the early neonatal period. Purpose. To assess the prevalence, predictors, and clinical outcomes of type 1 cardiorenal syndrome (AKI associated with impaired cardiac function) in neonates with congenital aortic arch pathology who underwent surgical treatment. Materials and methods. This retrospective cohort study included 95 neonates with CAP who underwent CHD correction at the Heart Center (Astana, Kazakhstan) between 2017 and 2024. Among a total of 402 pediatric patients with CHD, 15.6% developed AKI. The 95 neonates with CAP were divided into two groups: those with AKI (n=45) and those without (n=50). Demographic, intraoperative, and laboratory parameters were analyzed, including N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels, presence of sepsis, and duration of cardiopulmonary bypass (CPB). Results. The development of AKI in neonates with CAP was significantly associated with elevated postoperative NT-proBNP levels and the presence of sepsis. The duration of CPB did not show a statistically significant correlation with AKI. Patients with AKI required prolonged mechanical ventilation, longer intensive care unit stays, and had higher mortality rates. Conclusion. Early diagnosis and risk stratification for AKI in neonates with congenital aortic arch pathology are crucial for improving outcomes. NT-proBNP levels may serve as a potential biomarker for predicting the development of type 1 cardiorenal syndrome. Individualized perioperative management strategies are essential to reduce complications in this high-risk population.

acute kidney injury , congenital heart defects , neonatal surgery , NT-proBNP , risk factors

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Astana Medical University, Astana, Kazakhstan
Corporate Fund University Medical Center Heart Center, Astana, Kazakhstan
Belarusian State Medical University, Minsk, Belarus
Kazakh National Medical University named after S.D. Asfendiyarov, Almaty, Kazakhstan
Nazarbayev University School of Medicine, Astana, Kazakhstan

Astana Medical University
Corporate Fund University Medical Center Heart Center
Belarusian State Medical University
Kazakh National Medical University named after S.D. Asfendiyarov
Nazarbayev University School of Medicine

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