Key result
Adult patients with congenital heart disease had a substantially higher prevalence of chronic kidney disease compared to matched controls (4.5% vs 0.2%).
Why the study?
Patients with congenital heart disease present risk factors for chronic kidney disease, which is known to have a substantial negative impact on survival.
Cohort (n=2,611)
Absolute Event Rate: 4.5% vs 0.2%
Adult patients with congenital heart disease have a significantly higher prevalence of chronic kidney disease compared to controls, though only age independently predicts cardiovascular mortality.
CKD prevalence is higher in adult CHD; leaves open whether targeted screening improves outcomes.
Background: Patients with congenital heart disease (CHD) show risk factors for chronic kidney disease (CKD) and it is well known that CKD has a large negative impact on survival. Methods: Observational and prospective cohort study. Adult CHD patients and controls were matched for age and sex. Results: A total of 657 CHD adult patients (cases) and 1954 controls were studied. Median age in CHD patients was 30 (17–62) years and 373 (57%) were male. The prevalence of CKD (Glomerular filtration rate (GFR) < 60 mL/min/1.73 m2) was 0.2% and 4.5% in the control and CHD groups, respectively. Binary logistic regression analysis determined as risk factors for CKD in CHD patients: age [1.54 (1.04–1.28), p = 0.009], dyslipidemia [19.8 (1.35–301.1), p = 0.031], low iron concentration [0.96 (0.96–0.93), p = 0.048], cyanosis [25.7 (1.60–411.8), p = 0.022], and Down syndrome [46.8 (8.09–2710), p = 0.003]. During a follow-up time of 6.8 (1.2–10.5) years, cardiovascular mortality occurred in 31 patients with CHD showing, through the Kaplan–Meier test, a worse outcome among patients with CKD (p < 0.05) as was also seen in the univariate Cox regression survival analysis. However, after adjusting for other variables, this significance was lost, with age remaining as the unique independent prognostic factor. Conclusions: The prevalence of CKD was much higher in patients with CHD than in the control group; age, cyanosis, and Down syndrome were the predictors of a higher risk of CKD among CHD patients. Although CKD was associated with worse survival in CHD patients, only age was identified as an independent prognostic factor for cardiovascular mortality.
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Martínez‐Quintana et al. (2024) conducted a cohort in Congenital heart disease (n=2,611). Congenital heart disease vs. Age- and sex-matched controls was evaluated on Prevalence of chronic kidney disease (GFR < 60 mL/min/1.73 m2). Adult patients with congenital heart disease had a substantially higher prevalence of chronic kidney disease compared to matched controls (4.5% vs 0.2%).
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