Assessment of Potential Renal Dysfunction in Patients with Congenital Heart Disease after Biventricular Repair

Abstract

Background and ObjectivesThere are few reports on renal dysfunction in the remote period after biventricular repair, and biomarkers for early detection of renal dysfunction are not well understood. We examined whether early fluctuation of biomarkers of renal function occurs in the remote period after biventricular repair in patients with congenital heart disease (CHD).MethodsFourteen patients with CHD after biventricular repair were included. The examination values obtained by cardiac catheterization test and renal function indices based on blood and urine sampling were compared.ResultsThe median estimated glomerular filtration rate (eGFR) of creatinine was 113 mL/min/1.73 m2, and the median eGFR of cystatin C was 117 mL/min/1.73 m2. A urine albumin-to-creatinine ratio (UACR) ≥10 mg/gCr was considered a risk factor for cardiovascular disease in 6 (43%) patients. There was a significant difference in right ventricular ejection fraction and deviation in right ventricular end-diastolic volume from the normal value between the 2 groups divided by UACR. Cyanosis before biventricular repair was noted in 2 (25%) patients with UACR <10 mg/gCr and in 4 (67%) patients with UACR ≥10 mg/gCr.ConclusionsIncreased UACR was noted in 43% of patients. In patients with UACR ≥10 mg/gCr, right heart system abnormality was observed, and several patients had cyanosis before radical treatment. Measurement for UACR may be able to detect renal dysfunction early in the postoperative remote period.

JCS 2022 Guideline on Management and Re-Interventional Therapy in Patients With Congenital Heart Disease Long-Term After Initial Repair

“…1031,1032 Proteinuria is seen in >60% of patients in their 30 s. 1029 Microalbumin in the urine predicts subsequent cardiovascular events. 1033, 1034 The glomerulus is progressively sclerosed with deteriorating function; the so-called cyanotic nephropathy. 432,1032,1035 Angiotensin converting enzyme inhibitor seems effective in this respect, although no largescale study has been conducted to prove its effectiveness thus far (Class IIb).…”

Association Between Single-Nucleotide Polymorphisms of NKX2.5 and Congenital Heart Disease in Chinese Population: A Meta-Analysis

“…The gold standard for invasive prenatal diagnosis is classic cytogenetic analysis [8]. With the advancement of medical technology, the survival rate of patients with CHD has increased [9]. CHD is a multifactorial disease related to genetic and environmental factors [10].…”

Increased Urine Albumin-to-Creatinine Ratio-a Harbinger of Renal Dysfunction after Repair of Congenital Heart Disease?

“…In this issue of the Korean Circulation Journal , Oka et al 10) retrospectively investigated fluctuations of biomarkers of renal function in 14 patients with CHD in the remote period after biventricular repair. Of the 14 patients, they report increased urine albumin-to-creatinine ratio (UACR, ≥10 mg/gCr) in 6 patients (43%) with CHD in the remote period after biventricular repair.…”