The Annals of Thoracic Surgery, Vol 36, 167-172, Copyright © 1983 by The Society of Thoracic Surgeons
Renal function in children undergoing cardiac operations
EN Ellis, BH Brouhard and VR Conti
Because we sometimes observed large amounts of uric acid crystals in the
urine of infants and children after open-heart operations and since renal
insufficiency from any cause can be a serious complication of cardiac
procedures, 8 acyanotic and 5 cyanotic children were studied prospectively
by comparing several preoperative and postoperative measures of renal
function. There were no significant differences between the acyanotic and
cyanotic groups in terms of age, time on cardiopulmonary bypass, or other
preoperative variables. Postoperatively, children in both groups had a wide
range of free water clearances (CH2O), with some values in the range
reported to be diagnostic of renal insufficiency in adults. Since none of
these children had renal insufficiency by other criteria, CH2O may not be
as reliable an indicator of renal insufficiency in children. The major
difference between the cyanotic and acyanotic groups was seen in
postoperative serum uric acid levels (SUA); the mean SUA levels in the
acyanotic and cyanotic groups were 5.3 +/- 0.5 mg/dl (+/- standard error of
the mean) and 10.4 +/- 1.7 mg/dl (range, 8.0 to 15.5 mg/dl), respectively.
Since the hyperuricemia in the cyanotic children could not be related to
increased exogenous administration or decreased renal excretion, it is
probably caused by increased endogenous production and may be related to
the resolution of the cyanotic state.
