Acute kidney injury in an infant after cardiopulmonary bypass.

The infant who develops acute kidney injury (AKI) after cardiopulmonary bypass (CPB) surgery presents unique challenges and opportunities to the clinician and to the investigator interested in the study of AKI pathophysiology. Infants do not have many of the comorbid conditions that confound CPB outcome studies of adults. Because the timing of the AKI event is known in this clinical setting, collaboration between cardiology intensivists, nephrologists, and perfusion technologists is essential to minimize the impact of CPB on the kidney. Early institution of ultrafiltration in the operating room and renal replacement therapy in the postoperative period may decrease the proinflammatory milieu and its resultant systemic effects. In addition, early initiation of renal replacement therapy to prevent fluid overload may result in improved infant outcomes.