Effect of congenital heart disease on renal function in childhood.
BACKGROUND
Nephropathy is a well-known complication of congenital heart disease (CHD), and the risk of developing renal impairment is particularly high in patients with cyanotic CHD. Most investigations of renal impairment in CHD have involved patients 20 years and older. This study investigated renal tubule function in pediatric patients with CHD, and compared findings in cyanotic and acyanotic groups.


METHODS
Twenty children with acyanotic CHD, 23 children with cyanotic CHD, and 13 healthy children were enrolled. Blood and early morning urine samples were collected from each subject to measure urinary concentrations of sodium, microalbumin, creatinine, beta(2)-microglobulin, and N-acetyl-beta-D-glucosaminidase (NAG).


RESULTS
The age and sex distributions in the three groups were similar. Median fractional excretion of sodium (FeNa) and urinary NAG/creatinine were significantly higher in the cyanotic group than in the control group (p = 0.022 and p = 0.002, respectively). There were no statistically significant differences among the groups with respect to urinary beta(2)-microglobulin/creatinine, urinary microalbumin/creatinine or glomerular filtration rate.


CONCLUSIONS
Tubular injury can be detected before glomerular injury occurs even within the first decade of life in patients with cyanotic CHD.
Agras
Pinar Isik
PI
Department of Pediatric Nephrology, Baskent University, Ankara, Turkey. pinaris2001@yahoo.com <pinaris2001@yahoo.com>
Derbent
Murat
M
Ozcay
Figen
F
Baskin
Esra
E
Turkoglu
Suna
S
Aldemir
Derya
D
Tokel
Kurşat
K
Saatci
Umit
U
D000118:Acetylglucosaminidase / Q000378:metabolism*; D017677:Age Distribution; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism*; D006801:Humans; D007223:Infant; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism*; D007677:Kidney Function Tests / Q000379:methods / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D017678:Sex Distribution; D014421:Turkey / Q000453:epidemiology; D001613:beta 2-Microglobulin / Q000378:metabolism*
D015415:Biomarkers; D001613:beta 2-Microglobulin; D000118:Acetylglucosaminidase