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Effect of congenital heart disease on renal function in childhood

Pinar Isik Agras1, Murat Derbent, Figen Ozcay

  • 1Department of Pediatric Nephrology, Baskent University, Ankara, Turkey. pinaris2001@yahoo.com <pinaris2001@yahoo.com>

Nephron. Physiology
|January 8, 2005
PubMed

Insights

Pediatric patients with cyanotic congenital heart disease (CHD) show early signs of kidney tubular injury. This damage is detectable before glomerular issues arise, even in young children with cyanotic CHD.

Area of Science:

  • Pediatric Nephrology
  • Cardiology
  • Renal Physiology

Background:

  • Nephropathy is a known complication of congenital heart disease (CHD), with higher risks in cyanotic CHD patients.
  • Previous studies primarily focused on adult populations (≥20 years).
  • This study addresses the gap by investigating renal tubule function in pediatric CHD patients.

Purpose of the Study:

  • To investigate renal tubule function in pediatric patients with congenital heart disease (CHD).
  • To compare renal tubule function between pediatric patients with cyanotic CHD and acyanotic CHD.
  • To identify early markers of renal impairment in children with CHD.

Main Methods:

  • Enrolled 20 children with acyanotic CHD, 23 with cyanotic CHD, and 13 healthy controls.
  • Collected blood and urine samples for analysis.
  • Measured urinary sodium, microalbumin, creatinine, beta(2)-microglobulin, and N-acetyl-beta-D-glucosaminidase (NAG).

Main Results:

  • Median fractional excretion of sodium (FeNa) was significantly higher in the cyanotic group compared to controls (p=0.022).
  • Urinary NAG/creatinine levels were significantly elevated in the cyanotic group versus controls (p=0.002).
  • No significant differences were observed in urinary beta(2)-microglobulin/creatinine, microalbumin/creatinine, or glomerular filtration rate among groups.

Conclusions:

  • Tubular injury markers (FeNa, NAG) are elevated in pediatric cyanotic CHD patients.
  • Early detection of tubular injury is possible in children with cyanotic CHD.
  • Tubular damage can precede glomerular damage in pediatric cyanotic CHD, even within the first decade of life.
Abstract

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