# Practice Patterns and Outcomes of Hemodialysis in Infants Undergoing Congenital Heart Surgery... — GCMD Library

Lizzy Lee from Cincinnati Children's discusses a study on hemodialysis outcomes in infants after congenital heart surgery (CHS). Approximately 1% of infants undergoing CHS develop severe acute kidney injury (AKI) requiring dialysis, with a 1-year survival rate of 46% compared to 94% for those who don't need dialysis. The study highlights that hospitals with more frequent dialysis use showed significantly higher hospital and one-year survival rates, indicating the importance of specialized center experience for these critical cases.

Grant Chappell, Darren Turner, Amir Mehdizadeh-Shrifi, David Lehenbauer, Marco Ricci, Meghan M Chlebowski, Stuart L Goldstein, Awais Ashfaq, David L S Morales

Hemodialysis after infant congenital heart surgery (CHS) for acute kidney injury (AKI) presents a major challenge due to relatively low utilization, difficult vascular access and small patient size. Therefore, we performed a multi-institutional analysis for infants requiring hemodialysis post-CHS. The Pediatric Health Information System (PHIS) was queried for infants undergoing CHS from 2004 to 2024. Intermittent hemodialysis (iHD) and continuous renal replacement therapy (CRRT) were included, patients undergoing pre-CHS dialysis or post-CHS peritoneal dialysis during admission were excluded. High HD use centers were in the top 10% of HD usage while low HD use centers were all other centers. After CHS, 1% (332/31,634) of infants received a form of hemodialysis (HD); 61% (204/332) received CRRT, 11% (37/332) received iHD, 11% (36/332) received both, and 17% (55/332) had an unknown type. HD was provided in 2% (220/12,898) of neonates (< 31days-old at CHS) vs. 1% (112/18,736) of infants 31-365 days old (p < 0.001). One-year survival was lower in the dialysis vs. non-dialysis cohort (46% vs. 94%, p < 0.0001). CRRT patients had higher one-year survival vs. iHD (50% vs. 25%, weighted log-rank; p = 0.01), although there was no difference after adjustment upon multivariate analysis. HD infants at high HD use centers had improved hospital and 1-year survival vs. low HD use (66% vs. 23%; 67% vs. 28%, p < 0.0001). Infants requiring hemodialysis (iHD or CRRT) post-CHS suffer from poor outcomes with < 50% 1-year survival, with high HD use centers having triple the hospital survival and double the 1-year survival, suggesting modifiable factors may mitigate poor outcomes.

Type: video · 0 min · posted 2026-06-05
Canonical: https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128

## Chapters
- [0:00](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=0) Hemodialysis Outcomes After Infant Congenital Heart Surgery

## Statements
- "1% of infants develop severe acute kidney injury requiring dialysis after congenital heart surgery" — Lizzie Lee (epidemiological) [0:07](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=7)
- "One-year survival for infants requiring hemodialysis after congenital heart surgery is 46%" — Lizzie Lee (epidemiological) [0:14](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=14)
- "One-year survival for infants not requiring hemodialysis after congenital heart surgery is 94%" — Lizzie Lee (epidemiological) [0:14](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=14)
- "Most infants requiring dialysis after congenital heart surgery received continuous renal replacement therapy rather than intermittent dialysis" — Lizzie Lee (clinical) [0:23](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=23)
- "Hospitals that use dialysis more frequently had 3 times higher hospital survival for infants after congenital heart surgery" — Lizzie Lee (epidemiological) [0:33](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=33)
- "Hospitals that use dialysis more frequently had double the 1-year survival rate for infants after congenital heart surgery" — Lizzie Lee (epidemiological) [0:33](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=33)
- "Dialysis after infant heart surgery is rare" — Lizzie Lee (epidemiological) [0:39](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=39)
- "Outcomes for infants requiring dialysis after heart surgery may improve when treated at centers with more experience in using dialysis" — Lizzie Lee (clinical) [0:44](https://library.globalcastmd.com/watch/practice-patterns-and-outcomes-of-hemodialysis-in-infants-undergoing-congenital-heart-surgery-12128?t=44)

## Transcript
Does it matter where a baby receives care after heart surgery? I'm Lizzie Lee from Cincinnati Children's, and this is an article you should know about. After having congenital heart surgery, 1% of infants can develop severe acute kidney injury and require dialysis. In this study, for those that needed hemodialysis, their one-year survival was 46%, compared to 94% for those that did not. not need hemodialysis. Most received continuous renal replacement therapy rather than intermittent dialysis. What was the most interesting finding? Where the baby was treated mattered a lot. Hospitals that use dialysis more frequently had 3 times higher hospital survival and double the 1-year survival rate. So the takeaway is that dialysis after infant heart surgery is pretty rare. But outcomes may improve when they are treated at a center with more experience in using dialysis. Let us know what you think and stay tuned for articles that you should know about.

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Not medical advice · citation policy: https://library.globalcastmd.com/ai