The Kidney in Congenital Heart Disease — An Overview

Renal effects of the administration of contrast media during cardiac catheterisation were compared in two groups of patients with congenital heart diseases. Group A consisted of 21 patients with cardiac malformations, characterised primarily by left ventricular volume overload and known to be associated occasionally with left heart failure, such as: left to right shunts and left ventricular valvular defects. Group B consisted of 23 patients with lesions affecting the right ventricle which are rarely associated with left heart failure, such as: Tetralogy of Fallot and Pulmonic stenosis. Patients in Group A showed a significant increment in both plasma creatinine and uric acid levels in the 24 h following heart catheterisation. This observation was significantly more prominent in the older age group (above the age of 5 years). In Group B no changes in these parameters were encountered. Plasma renin activity and fractional sodium excretion increased and decreased respectively, by a similar degree in both groups in the 24 h following contrast media administration. No difference in renal tubular handling of uric acid was observed between both groups, nor did any of the patients studied demonstrate any degree of proteinuria or abnormality in the urine sediment, prior to or following heart catheterisation. We suggest that chronic pre-existing left ventricular overload should be considered a risk factor among the other known risk factors which promote the incidence of acute renal failure after contrast media administration.(ABSTRACT TRUNCATED AT 250 WORDS)

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Renal perfusion in experimental coarctation of the aorta during antihypertensive therapy

Uhari

Tarkka

Koskinen

1986

Pediatr Cardiol

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Renal perfusion and the effectiveness of antihypertensive therapy were evaluated in experimental coarctation. A sham operation was performed at the age of two months on one group of dogs (n = 5); coarctation of the thoracic aorta was produced at the same age in a second group (n = 7) which was not treated with antihypertensive drugs; and coarctation was similarly produced in a third group (n = 6) which was treated with antihypertensive drugs; the drug treatment was begun one month after the coarctation operation. After operation, all dogs were observed for seven months under similar circumstances. With high doses of antihypertensive agents (hydrochlorothiazide 25 mg/day, propranolol 80 mg/day, and prazosin 20 mg/day), the blood pressure decreased significantly in the coarctation with treatment group compared with the coarctation without treatment group. Renal perfusion, when measured by xenon-133 washout at the age of five months, was similar in the coarctation without drug treatment and control groups but significantly lower (23% decrease, p less than 0.01) in the coarctation with drug treatment group; renal perfusion was similar in all three groups when measured at the ages of eight and nine months. The observed temporary decrease suggests a need to evaluate renal perfusion during antihypertensive treatment in coarctation in man.

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The Kidney in Congenital Heart Disease — An Overview

Cited by 5 publications

References 147 publications

Postoperative Care of Cardiac Patients

Postoperative Care of Cardiac Patients

The renal effects of radiocontrast administration during cardioangiography in two different groups with congenital heart disease

Renal perfusion in experimental coarctation of the aorta during antihypertensive therapy

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