INCIDENCE OF RENAL DYSFUNCTION IN ADULTS WITH CYANOTIC CONGENITAL HEART-DISEASE

Nephropathy has long been recognized as a potential complication of cyanotic congenital heart disease (CHD).1 Previous studies have demonstrated that glomerular enlargement, mesangial hypercellularity, glomerular capillary congestion and segmental sclerosis occur in some patients with cyanotic CHD.1 Functional abnormalities including decreased renal plasma flow and glomerular filtration rate, azotemia, abnormal uric acid secretion, proteinuria and nephrotic syndrome also occur in some patients with cyanotic CHD.2-5 The incidence of renal abnormalities increases with the degree of cyanosis and accompanying erythrocytosis. 2 Previous studies2,3 and our clinical experience suggest that the incidence of renal abnormalities may also increase with increasing duration of cyanosis. Owing to advances in cardiovascular surgery, growing numbers of patients with cyanotic CHD are now surviving longer into adulthood and may be at risk for developing renal abnormalities that may significantly influence their clinical course.4 To our knowledge, the incidence of renal abnormalities in a clinical population of adult patients with unrepaired cyanotic CHD has not been previously reported. © 1991.