title: Comparison of renal function between cyanotic and acyanotic congenital heart disease in children and adolescent.
abstract: BACKGROUND
  Glomerular and tubular dysfunction can be found in congenital heart disease (CHD) especially in older children and adults.
  
  
  OBJECTIVE
  To evaluate the prevalence renal dysfunction and to compare glomerular and tubular function between cyanotic and acyanotic CHD in children and adolescent. Correlations among clinicalfactors, urinary glomerular and tubular markers for kidney injury were also determined.
  
  
  METHODS
  Renal function was determined by estimated glomerular filtration rate, urine protein/creatinine, urine microalbumin/creatinine, FE Na+, FE Mg2, and urine NAG/creatinine in children and adolescent with CHD.
  
  
  RESULTS
  Forty-six patients, 15 cyanotic (group 1), and 31 acyanotic CHD (group 2), were studied. Only the differences of urine NAG/creatinine (median, 3.59 vs. 1.64 unit/gram creatinine; p = 0.008), FE Mg2+ (mean, 5.03 +/- 3.61% vs. 2.48 +/- 1.8%; p = 0.019), and urine protein/creatinine between the two groups were statistically significant (0.16 vs. 0.08; p = 0.001). No significant differences of clinical features, BUN, creatinine, eGFR, diastolic blood pressure, FE Na+, and urine microalbumin/creatinine were found between the two groups. Significantly higher prevalence ofabnormal biochemical markers in group 1 compared to those of group 2:86.6% vs. 43.38% (p = 0.02) for FE Mg2+; 46.6% vs. 9.67% (p = 0.008) for urine NAG/creatinine; 46.6% vs. 6.45% for significant proteinuria (p = 0.003); and 40% and 9.67% (p = 0.042) for microalbuminuria, respectively. The authors found moderate correlation between hemoglobin and functional class of the patients (r = 0.58) and highly negative correlation between oxygen saturation and functional class (r = -0.716). The relationships among other clinical or biochemical makers showed only low correlations.
  
  
  CONCLUSIONS
  Cyanotic CHD patients had more prevalence and higher abnormal biochemical markers for renal dysfunction than those of acyanotic CHD. Their urine protein/creatinine, FE Mg2 and urine NAG/creatinine were higher than those of acyanotic CHD. Only low correlation among biochemical markers was found
authors: Department ofPediatrics, Faculty ofMedicine, Vajira Hospital, Bangkok, Thailand. yupa63@yahoo.com
authors: Yupaporn
authors: Y
authors: Amornchaicharoensuk
authors: Thewarug
authors: T
authors: Werawatganon
authors: Piyarut
authors: P
authors: Tohsukhowong
authors: Chanchai
authors: C
authors: Boonla
authors: Aungkana
authors: A
authors: Gengsakul
authors: Thanakrit
authors: T
authors: Tarunotai
authors: Piya
authors: P
authors: Samankatiwat
authors: Mala
authors: M
authors: Treewatchareekorn
mesh_terms: D000293:Adolescent; D000419:Albuminuria / Q000453:epidemiology; D002648:Child; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D003490:Cyanosis / Q000453:epidemiology*; D005919:Glomerular Filtration Rate; D006330:Heart Defects, Congenital / Q000453:epidemiology*; D006801:Humans; D011507:Proteinuria / Q000453:epidemiology
chemical_list: D003404:Creatinine