MORPHOLOGICAL PICTURE OF ACUTE KIDNEY INJURY IN YOUNG CHILDREN AFTER CARDIAC SURGERY

Introduction. The most common complication in young children after cardiac surgery is perioperative acute kidney injury. This condition is associated with a high mortality risk and significant morphological changes in the kidneys, which require complex and timely treatment. Aim: To improve the outcomes of combined postoperative treatment in young children with acute kidney injury by assessing the morpho-functional structures of the kidneys, as well as the effectiveness of early peritoneal dialysis. Materials and Methods: Clinical and anatomical analysis was performed on the material of 23 young children who died after cardiac surgery that had included correction of congenital heart defects. Morphological studies included investigation of their medical histories, post-mortem examinations, and histological examinations of renal tissues. Results and Discussion. Hemodynamic disturbances were recorded on the 1st and 2nd days after surgery, including a decrease in hourly diuresis and an increase in serum creatinine levels. The main morphological changes included necrosis of convoluted tubule nephrocytes in 48.6% of cases and dystrophic changes in 51.3% of cases, which was accompanied by multiple organ failure. Conclusions. After the use of cardiotropic and nephroprotective therapy, including early peritoneal dialysis, some children showed restoration of nephrons with the formation of cellular cylinders and fixation of osmolar dialysate in the loop of Henle.