Related Experiment Video
Updated: Jun 5, 2025
08:50
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
16.2K
Deterioration in Renal Function in Patients With a Fontan Circulation and Association With Mortality.
Gaston van Hassel1, Dion Groothof2, Johannes M Douwes1
1Center for Congenital Heart Diseases, Paediatric Cardiology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
JACC. Advances
|December 4, 2024
Summary
Patients with Fontan circulation experience faster kidney function decline than healthy individuals. This deterioration is linked to higher NT-proBNP levels and increased mortality risk.
Area of Science:
- Cardiology
- Nephrology
- Pediatric Cardiology
Background:
- Renal dysfunction is a known cardiovascular disease risk factor.
- Little is known about renal function changes in Fontan circulation patients.
- This study addresses the prevalence and factors of renal function deterioration in this population.
Purpose of the Study:
- To investigate the course of renal function in Fontan circulation patients.
- To identify factors associated with renal function deterioration.
- To examine the association between renal function and mortality.
Main Methods:
- Longitudinal study of 82 Fontan circulation patients over 11 years.
- Measured creatinine-based estimated glomerular filtration rate (eGFRcr).
- Assessed cystatin C, NT-proBNP, and used linear mixed-effect models and joint models for survival analysis.
Main Results:
- Median age at baseline was 20 years.
- 12% had renal dysfunction by eGFRcr, 24% by eGFRcys.
- eGFRcr declined by 1.36 ml/min/1.73 m²/year, faster than healthy controls.
- Higher baseline NT-proBNP z-scores correlated with faster eGFRcr decline.
- Greater eGFRcr decline was associated with all-cause mortality.
Conclusions:
- Fontan circulation patients exhibit accelerated eGFRcr decline compared to healthy individuals.
- Elevated baseline NT-proBNP z-scores predict more rapid renal function deterioration.
- Progressive eGFRcr decline is a significant predictor of mortality in this cohort.
Related Concept Videos
01:17Factors Affecting Renal Clearance: Renal Impairment
53
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
53
01:22Heart Failure Drugs: Diuretics
340
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
340
01:27Dialysis
264
Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
264
01:11Renal Failure: Dose Adjustments
63
In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
63
01:20Renal Corpuscle
1.7K
The glomerulus and Bowman's capsule are two essential components of the nephron, which is the functional unit of the kidney. These microscopic structures play a critical role in the process of blood filtration to produce urine.
Glomerulus: Structure and Function
The glomerulus is a tiny, intricate network of capillaries located at the beginning of the nephron. It's enveloped by the Bowman's capsule and receives its blood supply from an afferent arteriole, which divides into numerous...
Glomerulus: Structure and Function
The glomerulus is a tiny, intricate network of capillaries located at the beginning of the nephron. It's enveloped by the Bowman's capsule and receives its blood supply from an afferent arteriole, which divides into numerous...
1.7K
01:17Aortic Regurgitation IV: Nursing Management
9
A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
9