Objective:
To investigate the incidence, implicating factors and outcome of acute renal failure after cardiac surgery with cardio pulmonary bypass for congenital cardiac defects in children less than 16 years of age.

Design:
Retrospective study.

Setting:
15 bedded pediatric intensive care unit in a tertiary referral centre

Patients:
One hundred and ninety three children (less than sixteen years of age) who underwent cardiac surgery with or without cardiopulmonary bypass between January 2008 and October 2008

Measurements and Main Results:
Baseline admission urea (mg/dl) and creatinine (mg/dl) serum levels and highest urea and creatinine levels were measured. Urine output (ml/kg/hour) and frusemide dose (mg/kg/day) were also noted. A baseline inotrope score was calculated on admission and the highest inotrope score was noted based on maximum infused doses of inotrope in the first 36 hours. The surgical procedure was used to determine a Aristotle score. Of the 193 children who underwent cardiopulmonary bypass, 10 children (5.2%) developed acute renal injury (doubling of creatinine/ urine output<0.5 ml/kg).Out of these, 3 died due to irreversible pulmonary arterial hypertension and low cardiac output. 6 were subjected to elective ECMO for their cardiac status (ECMO duration 24 - 48 hours), however none of them developed acute renal injury. Low cardiac output was the only significant risk factor identified for developing acute renal injury or failure.