Early Post-Op APAP Exposure May Cut AKI Risk in Peds Cardiac Sx
TUESDAY, May 15, 2018 -- For pediatric patients undergoing cardiac surgery, early postoperative acetaminophen exposure may be associated with a reduced rate of acute kidney injury (AKI), according to a study published online May 14 in JAMA Pediatrics.
Sara L. Van Driest, M.D., Ph.D., from the Vanderbilt University School of Medicine in Nashville, Tenn., and colleagues conducted a retrospective cohort study involving primary and validation cohorts of children older than 28 days admitted for cardiac surgery. The authors examined whether early postoperative acetaminophen exposure correlated with reduced risk of AKI.
The primary cohort included 666 children with a median age of 6.5 months; 51.2 percent had AKI. The researchers found that those with AKI had lower median acetaminophen doses than those without AKI, in unadjusted analyses (47 versus 78 mg/kg). Acetaminophen exposure was protective against postoperative AKI after adjustment for multiple confounding variables (odds ratio, 0.86 per each additional 10 mg/kg). Findings were replicated in the validation cohort, which included 333 infants with a median age of 14.1 months; 48.6 percent had AKI. Acetaminophen doses were 60 and 70 mg/kg in those with and without AKI, respectively, with an adjusted odds ratio of 0.91 for each additional 10 mg/kg.
"Further analysis to validate these findings, potentially through a prospective, randomized trial, may establish acetaminophen as a preventive agent for AKI," the authors write.
One author disclosed financial ties to Merck.
Posted: May 2018