Morphological substrate of cardiac surgery-associated acute kidney injury in young children: Clinico-morphological correlations with biomarkers and perfusion parameters

The diagnosis of cardiac surgery-associated acute kidney injury (CS-AKI) in children relies mainly on functional criteria — serum creatinine and urine output — and increasingly on biomarkers of tubular injury. However, the structural basis of CS-AKI in young children after surgery with cardiopulmonary bypass (CPB) has been studied far less. The relationship between the severity of tubular damage, biomarker response, oxygen delivery during CPB and postoperative venous congestion remains insufficiently defined, which limits the pathophysiological interpretation of early diagnostic markers [1–4].