Renal dysfunction is common among adults after palliation for previous tetralogy of Fallot. Pediatr Cardiol 2013 Jan;34(1):165-9
Date
06/08/2012Pubmed ID
22673967DOI
10.1007/s00246-012-0408-3Scopus ID
2-s2.0-84872594728 (requires institutional sign-in at Scopus site) 16 CitationsAbstract
Long-term survival after tetralogy of Fallot (TOF) repair is excellent. However, little is published regarding late noncardiac complications. This study aimed to determine the prevalence and risk factors for renal dysfunction among adults after TOF repair. For this study, 56 adult patients with complete repair of TOF were identified, and their charts were retrospectively reviewed. An estimated glomerular filtration rate (eGFR) for each patient was calculated using the Modification of Diet in Renal Disease formula (MDRD). Using each patient's eGFR, he or she was classified into stages based on the National Kidney Foundation chronic kidney disease (CKD) staging. Clinical parameters were compared among patients with and those without renal dysfunction to identify risk factors for renal impairment. The median estimated eGFR rate for the cohort was 78 ml/min/1.73 m(2). Based on the National Kidney Foundation CKD staging system, 54 % of the patients had at least stage 2 chronic renal disease. The risk factors identified were hypertension (p < 0.01), type 2 diabetes mellitus (p < 0.05), longer follow-up evaluation (p < 0.005), older age at complete repair (p < 0.05), and use of daily diuretics (p < 0.05). After repair of TOF, renal dysfunction is common at late follow-up evaluation. The study findings show the importance of routine assessment of renal function and the need to limit or avoid future episodes of acute kidney injury in this at-risk population.
Author List
Buelow MW, Dall A, Bartz PJ, Tweddell JS, Sowinski J, Rudd N, Katzmark L, Earing MGAuthors
Peter J. Bartz MD Chief, Professor in the Pediatrics department at Medical College of WisconsinMatthew W. Buelow MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
Aaron Dall MD Associate Professor in the Medicine department at Medical College of Wisconsin
Lindsey M. Katzmark RN APP Hybrid in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Kidney
Male
Middle Aged
Palliative Care
Prevalence
Renal Insufficiency, Chronic
Retrospective Studies
Risk Assessment
Risk Factors
Tetralogy of Fallot
Young Adult
