Korean Circ J.  2018 May;48(5):418-426. 10.4070/kcj.2017.0017.

Assessment of Potential Renal Dysfunction in Patients with Congenital Heart Disease after Biventricular Repair

Affiliations
  • 1Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan. oka5p@asahikawa-med.ac.jp

Abstract

BACKGROUND AND OBJECTIVES
There are few reports on renal dysfunction in the remote period after biventricular repair, and biomarkers for early detection of renal dysfunction are not well understood. We examined whether early fluctuation of biomarkers of renal function occurs in the remote period after biventricular repair in patients with congenital heart disease (CHD).
METHODS
Fourteen patients with CHD after biventricular repair were included. The examination values obtained by cardiac catheterization test and renal function indices based on blood and urine sampling were compared.
RESULTS
The median estimated glomerular filtration rate (eGFR) of creatinine was 113 mL/min/1.73 m2, and the median eGFR of cystatin C was 117 mL/min/1.73 m2. A urine albumin-to-creatinine ratio (UACR) ≥10 mg/gCr was considered a risk factor for cardiovascular disease in 6 (43%) patients. There was a significant difference in right ventricular ejection fraction and deviation in right ventricular end-diastolic volume from the normal value between the 2 groups divided by UACR. Cyanosis before biventricular repair was noted in 2 (25%) patients with UACR < 10 mg/gCr and in 4 (67%) patients with UACR ≥10 mg/gCr.
CONCLUSIONS
Increased UACR was noted in 43% of patients. In patients with UACR ≥10 mg/gCr, right heart system abnormality was observed, and several patients had cyanosis before radical treatment. Measurement for UACR may be able to detect renal dysfunction early in the postoperative remote period.

Keyword

Kidney; Renal dysfunction; Microalbumin; Congenital heart disease; Biventricular repair

MeSH Terms

Biomarkers
Cardiac Catheterization
Cardiac Catheters
Cardiovascular Diseases
Creatinine
Cyanosis
Cystatin C
Glomerular Filtration Rate
Heart
Heart Defects, Congenital*
Humans
Kidney
Reference Values
Risk Factors
Stroke Volume
Biomarkers
Creatinine
Cystatin C

Figure

  • Figure 1 Patient selection flow.


Cited by  1 articles

Increased Urine Albumin-to-Creatinine Ratio-a Harbinger of Renal Dysfunction after Repair of Congenital Heart Disease?
Soo Jung Kang
Korean Circ J. 2018;48(5):435-437.    doi: 10.4070/kcj.2018.0128.


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