May 17, 2018
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Findings link early postoperative acetaminophen exposure with lower AKI rate in pediatric patients

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Sara L. Van Driest
 

Among pediatric patients who undergo cardiac surgery, early postoperative acetaminophen exposure may be associated with a lower rate of acute kidney injury, according a study published in JAMA Pediatrics. Further analysis of these findings could establish acetaminophen as a preventative agent for acute kidney injury.

“In our study, we found that children who underwent cardiac surgery were less likely to have postoperative [acute kidney injury] AKI if they received acetaminophen in the first 48 hours after surgery, even after we took measure to adjust for how sick the patients were, the length of cardiac surgery and other risk factors for acute kidney injury,” Sara L. Van Driest, MD, PhD, lead author of the study from Vanderbilt University School of Medicine, told Healio Nephrology. “The more acetaminophen they received, the lower the risk for AKI.”

To determine whether acetaminophen may reduce the risk of AKI, researchers performed a retrospective cohort study of children admitted to two tertiary referral children’s hospitals. The study took place from July 1, 2008 to June 1, 2016 and included children older than 28 days of age.

A total of 666 children were included in the study. The median age was 6.5 months, and 341 patients had AKI. Unadjusted analyses revealed patients with AKI had lower median acetaminophen doses than patients without AKI.

“In logistic regression analysis adjusting for age, cardiopulmonary bypass time, red blood cell distribution width, postoperative hypotension, nephrotoxin exposure and risk adjustment for congenital heart surgery score, acetaminophen exposure was protective against postoperative AKI,” the investigators wrote. – by Jake Scott

 

Disclosures: Van Driest reports support by NIH/NCATS KL2 TR000446. Please see the study for all other authors’ relevant financial disclosures.