| Abstrakt: |
Extract: Thirty 133Xe determinations of renal blood flow were made in 20 children ranging in age from 16/12 to 10 9/12 years. In six normal kidneys average blood flows to the outer and inner cortex were 374 and 44 ml/min/100 g, respectively. Mean fractional flows to these areas were 84 and 15 ml/min/100 g, respectively. In nine children with congenital heart disease (CHD) who were not in congestive heart failure and who were evaluated before angiography, a defect in outer cortical flow was demonstrated. Average blood flows to the outer and inner cortex were 250 ml/min/100 g (P 0.0005) and 27 ml/min/100 g (P 0.22). Mean fractional flows were 76% (P 0.03) and 24% (P 0.015), respectively.After cardiac angiography, a decrease in outer conical flow occurred. The second flow study was performed 8–30 min after injection of contrast media (Hypaque-M, 75%) in amounts which ranged from 1.2 to 3.5 ml/kg body wt. After angiography, blood flows to the outer and inner cortex were 186 ml/min/100 g (P 0.001) and 24.5 ml/min/100 g (P 0.68). Average fractional flow to the outer, 74% and inner, 26% cortex, did not change (P 0.71).Speculation: Kidneys of children with CHD have decreased outer cortical flow, which may result in increased renal renin production. Therefore, a child with CHD may suffer the long term consequences of hyperreninemia. Furthermore, the balance of any metabolic system whose metabolic pathways involve the outer cortex may be altered and hemodynamic response to stressful clinical situations may be greater in the kidneys of children. |
