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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
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Albuminuria Prevalence in Fontan Patients: A Systematic Review and Meta-Analysis.
Hannah Van Belle1, Jef Van den Eynde1, Aleksandra Cieplucha1,2
1Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.
Pediatric Cardiology
|December 17, 2024
Summary
Albuminuria, a marker of kidney injury, is common in Fontan circulation patients. This urinary albumin-to-creatinine ratio (UACR) elevation is more prevalent than reduced glomerular filtration rate (GFR), suggesting UACR
Area of Science:
- Cardiology
- Nephrology
- Pediatric Cardiology
Background:
- Patients with Fontan circulation face increased risk of chronic kidney disease (CKD).
- CKD is defined by reduced glomerular filtration rate (GFR) or elevated urinary albumin-to-creatinine ratio (UACR).
Purpose of the Study:
- To determine the prevalence of albuminuria in patients with Fontan circulation.
- To assess the clinical determinants of albuminuria in this population.
Main Methods:
- Systematic review and meta-analysis of studies from MEDLINE, EMBASE, Trip, and Cochrane databases.
- Inclusion criteria: studies reporting albuminuria prevalence in Fontan patients; exclusion criteria: case reports, reviews, pre-Fontan, or post-heart transplant patients.
- Quality effects model used for meta-analysis; bias assessment performed.
Main Results:
- Pooled prevalence of albuminuria was 28.4% (95% CI 23.5-33.5%) across 11 studies (873 patients).
- Glomerular filtration rate (GFR) was generally preserved in the studied patients.
- Albuminuria showed association with elevated systemic venous pressure in 5 studies; other associations were inconclusive.
Conclusions:
- Albuminuria is more prevalent than reduced GFR in Fontan circulation patients.
- Urinary albumin-to-creatinine ratio (UACR) may be a valuable screening tool for CKD in this population, alongside GFR.
- Limitations include predominantly retrospective/cross-sectional designs and small, heterogeneous study populations.
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