title: Repeated phlebotomies improve and stabilise renal function in cyanotic nephropathy.
abstract: Patients over 10 years of age with cyanotic congenital heart disease (CCHD) risk developing significant glomerular proteinuria, a condition called cyanotic nephropathy. Even though the pathogenesis of glomerulopathy associated with CCHD is still unclear, a potential mechanism is hyperviscosity-induced decrease in peritubular capillary blood flow leading to an increase in glomerular capillary pressure, in turn resulting in proteinuria. Although angiotensin-converting enzyme (ACE) inhibitors have been traditionally used in the treatment of these patients with cyanotic nephropathy, they may, however, not be well tolerated. Here we present a case of an adult patient with CCHD who could not tolerate an ACE inhibitor but showed improvement and stabilisation of her renal function following treatment with repeated phlebotomies.
authors.affiliation: North Shore University Hospital, Department of Pulmonary, Critical Care and Sleep Medicine, Suite 107, 410 Lakeville Road, New Hyde Park, NY 11042, USA.
authors.forename: Kennedy O
authors.initials: KO
authors.lastname: Omonuwa
authors.forename: Arunabh
authors.initials: A
authors.lastname: Talwar
authors.forename: Sophy
authors.initials: S
authors.lastname: Dedopoulos
authors.forename: Lionel U
authors.initials: LU
authors.lastname: Mailloux