Serum and 24-hour urine analysis in adult cyanotic and noncyanotic congenital heart disease patients.

INTRODUCTION

Glomerulopathy is a complication of congenital heart disease patients. The risk of developing renal impairment is particularly high in cyanotic patients.

OBJECTIVE

The aim of this study was to determine the prevalence of renal dysfunction and microalbumiuria in adult cyanotic and non cyanotic congenital heart disease patients.

METHODS

Fourteen cyanotic and 22 noncyanotic congenital heart disease patients were studied in the Adult Congenital Heart Disease Unit at the Complejo Hospitalario Universitario Insular-Materno Infantil. Demographic characteristics, complete blood count, and 24-hour urianalysis were obtained, including abdominal ultrasound in those with cyanosis.

RESULTS

No differences were seen between age (years) (27.4 +/- 8.2; 26.4 +/- 8.3; P = .71), sex, size, weight, or glomerular filtration rate (mL/min/1.73 m(2)) (81.1 +/- 22.9 vs. 84.9 +/- 9.2, P = .482) between cyanotic and noncyanotic patients. However, Eisenmenger patients had significantly impaired renal function when compared with noncyanotic patients (73.0 +/- 17.3 vs. 84.9 +/- 9.2 mL/min/1.73 m(2), P = .023). Significant differences were obtained in oxygen saturation (%) (83.8 +/- 5.8 vs. 97.8 +/- 0.8; P = .000), hematocrit (%) (59.3 +/- 8.1 vs. 40.9 +/- 8.5; P = .000), platelets (10(3)/microL) (161.5 +/- 70.5 vs. 277.9 +/- 57.6; P = .000), serum uric acid (mg/dL) (7.5 +/- 2.3 vs. 5.6 +/- 1.5; P = .008) and microalbuminuria (mg/24 hours) (12.8 [0, 700.2] vs. 2.4 [0, 18.9]; P = .000) between cyanotic and noncyanotic patients. Five cyanotic patients (35.7%) had microalbuminuria (>30 mg/24 hours) and three of them (21.4%) proteinuria (>1 g/24 hours). No significant differences were seen between serum and urine parameters between cyanotic patients who had microalbuminuria (>30 mg/24 hours) and those cyanotic patients who did not have it (<30 mg/24 hours).

CONCLUSIONS

Renal impairment is frequently seen in congenital heart disease patients, being associated occasionally with proteinuria and microalbuminuria in cyanotic ones.