Follow-up after neonatal heart disease repair: watch out for chronic kidney disease and hypertension!

Autor: Daniel Garros, Rachel Joffe, Erin Hessey, Louis Huynh, Michael Zappitelli, Ari R. Joffe, Andrew S. Mackie, Michael Pizzi, Ana Palijan, Kelly Benisty, Adrian Dancea, Alex Paun, Sara Rodriguez-Lopez, Catherine Morgan
Rok vydání: 2020
Předmět:
Heart Defects
Congenital
Male
Nephrology
medicine.medical_specialty
Heart disease
030232 urology & nephrology
Renal function
Outcomes
urologic and male genital diseases
03 medical and health sciences
chemistry.chemical_compound
Neonate
0302 clinical medicine
Chronic kidney disease
030225 pediatrics
Internal medicine
medicine
Humans
Single-Blind Method
Longitudinal Studies
Prospective Studies
Cardiac Surgical Procedures
Child
Congenital heart disease
Creatinine
business.industry
Infant
Newborn
Acute kidney injury
Acute Kidney Injury
medicine.disease
female genital diseases and pregnancy complications
3. Good health
Blood pressure
chemistry
Case-Control Studies
Hypertension
Pediatrics
Perinatology and Child Health
Original Article
Female
business
Glomerular Filtration Rate
Cohort study
Kidney disease
Zdroj: Pediatric Nephrology (Berlin, Germany)
ISSN: 1432-198X
0931-041X
DOI: 10.1007/s00467-020-04621-4
Popis: Background With advances in care, neonates undergoing cardiac repairs are surviving more frequently. Our objectives were to 1) estimate the prevalence of chronic kidney disease (CKD) and hypertension 6 years after neonatal congenital heart surgery and 2) determine if cardiac surgery-associated acute kidney injury (CS-AKI) is associated with these outcomes. Methods Two-center prospective, longitudinal single-visit cohort study including children with congenital heart disease surgery as neonates between January 2005 and December 2012. CKD (estimated glomerular filtration rate 2 or albumin/creatinine ≥3 mg/mmol) and hypertension (systolic or diastolic blood pressure ≥ 95th percentile for age, sex, and height) prevalence 6 years after surgery was estimated. The association of CS-AKI (Kidney Disease: Improving Global Outcomes definition) with CKD and hypertension was determined using multiple regression. Results Fifty-eight children with median follow-up of 6 years were evaluated. CS-AKI occurred in 58%. CKD and hypertension prevalence were 17% and 30%, respectively; an additional 15% were classified as having elevated blood pressure. CS-AKI was not associated with CKD or hypertension. Classification as cyanotic postoperatively was the only independent predictor of CKD. Postoperative days in hospital predicted hypertension at follow-up. Conclusions The prevalence of CKD and hypertension is high in children having neonatal congenital heart surgery. This is important; early identification of CKD and hypertension can improve outcomes. These children should be systematically followed for the evolution of these negative outcomes. CS-AKI defined by current standards may not be a useful clinical tool to decide who needs follow-up and who does not.
Databáze: OpenAIRE
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