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Renal function and injury in infants and young children with congenital heart disease

Jianyong Zheng1, Yong Yao, Ling Han

  • 1Center for Cardiovascular Diseases, PLA Navy General Hospital, Beijing, People's Republic of China. windywarrior@hotmail.com

Pediatric Nephrology (Berlin, Germany)
|August 28, 2012
PubMed

Insights

Congenital heart disease (CHD) in young children can cause kidney injury, particularly tubular damage in those with severe cyanosis. Glomerular damage was also observed in some severe cases.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Research
  • Biomarker Discovery

Background:

  • Congenital heart disease (CHD) affects renal function in infants and children.
  • Early identification of renal injury in pediatric CHD is crucial.

Purpose of the Study:

  • To investigate renal function and injury in infants and young children with CHD.
  • To assess kidney biomarkers in different CHD severity groups.

Main Methods:

  • Prospective enrollment of 58 children with CHD (aged ≤3 years) and 20 controls.
  • Categorization into acyanotic CHD, cyanotic CHD (high/low oxygen saturation), and normal control groups.
  • Measurement of urinary microalbumin (MA), N-acetyl-ß-D-glucosaminidase (NAG), and α1-microglobulin (α1-MG) corrected by creatinine (UCr).

Main Results:

  • Elevated urinary α1-MG/UCr levels were observed in CHD patients, highest in severe cyanosis (Group III).
  • Higher urinary NAG/UCr levels were found in acyanotic (Group I) and severe cyanotic (Group III) CHD.
  • Urinary MA/UCr levels were significantly higher in all CHD groups compared to controls.
  • Glomerular damage indicators (α1-MG/(α1-MG+MA) <15%) were present in some patients with advanced heart failure or severe cyanosis.

Conclusions:

  • Tubular renal injury is prevalent in infants and young children with CHD.
  • Severe cyanosis in CHD is associated with the most prominent tubular injury.
  • Glomerular injury can occur in a subset of pediatric CHD patients, particularly those with severe cyanosis or heart failure.
Abstract

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