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Chronic Kidney Disease in Adolescents after Surgery for Congenital Heart Disease.
Cardiorenal Medicine ( IF 3.8 ) Pub Date : 2020-07-28 , DOI: 10.1159/000508177
Mirela Bojan 1 , Laurence Pieroni 2 , Cristian Mirabile 3 , Marc Froissart 4, 5 , Damien Bonnet 6, 7
Affiliation  

Background: The onset of chronic kidney disease (CKD) is an important prognostic factor in young adults with congenital heart disease (CHD). Although it is likely that CKD is manifest early in CHD patients, the prevalence among adolescents is still unknown. The National Kidney Foundation’s Kidney Disease Improving Global Outcomes guidelines 2012 recommend new equations for the estimated glomerular filtration rate (eGFR) and highlight the importance of albuminuria for CKD screening. The objective of the present study was to estimate the prevalence of CKD in CHD adolescents. Methods: This observational cross-sectional study included 115 patients aged 10–18 years attending the cardiologic outpatient clinic at our institution as a follow-up after cardiac surgery in infancy related to various CHDs. CKD assessment used the CKD criteria 2012, including eGFR equations based on serum creatinine and cystatin C, and measurement of albuminuria. Results: No patient had an eGFR #x3c;60 mL min–1 1.73 m–2. However, 28.7% of all patients (95% CI 20.7–37.9) had eGFRbetween 60 and 89 mL min–1 1.73 m–2 when estimated by the bedside Schwartz creatinine-based equation,and 17.4% (95% CI 11.2–24.1) had eGFRbetween 60 and 89 mL min–1 1.73 m–2 when estimated by the Zappitelli equation, combining creatinine and cystatin C. Of all patients, 20.0% (95% CI 12.1–26.7) had orthostatic proteinuria, and none had persistent albuminuria. Conclusions: There was no evidence of CKD in the present population aged 10–18 years. The significance of an eGFR between 60 and 90 mL min–1 1.73 m–2 is not concordant for this age range and requires further investigations.
Cardiorenal Med


中文翻译:

先天性心脏病手术后青少年慢性肾病。

背景:慢性肾病(CKD)的发病是年轻成人先天性心脏病(CHD)的重要预后因素。尽管 CKD 很可能在 CHD 患者早期表现出来,但在青少年中的患病率仍然未知。美国国家肾脏基金会的肾脏疾病改善全球结果指南 2012 推荐了估计肾小球滤过率 (eGFR) 的新方程,并强调了蛋白尿对 CKD 筛查的重要性。本研究的目的是估计 CHD 青少年 CKD 的患病率。方法:这项观察性横断面研究包括 115 名年龄在 10-18 岁的患者,他们在我们机构的心脏门诊就诊,作为与各种 CHD 相关的婴儿心脏手术后的随访。CKD 评估使用 2012 年 CKD 标准,包括基于血清肌酐和胱抑素 C 的 eGFR 方程,以及蛋白尿的测量。结果:没有患者的 eGFR #x3c;60 mL min –1 1.73 m –2。然而,所有患者中有 28.7% (95% CI 20.7–37.9) 有 eGFR在 60 到 89 mL min –1 1.73 m –2 之间,当通过基于床边 Schwartz 肌酐的方程估计时,17.4% (95% CI 11.2–24.1) 有 eGFR60 至 89 mL min –1 1.73 m –2根据 Zappitelli 方程估计,结合肌酐和胱抑素 C。在所有患者中,20.0% (95% CI 12.1-26.7) 有直立性蛋白尿,没有人有持续性蛋白尿。结论:目前 10-18 岁的人群中没有 CKD 的证据。eGFR 在 60 到 90 mL min –1 1.73 m –2之间的显着性与该年龄范围不一致,需要进一步调查。
心肾医学
更新日期:2020-07-28
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