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Vol. 81, No. 3, 1999
Issue release date: March 1999
Section title: Original Paper
Nephron 1999;81:296–300
(DOI:10.1159/000045296)

Renal Function in Cyanotic Congenital Heart Disease

Burlet A. · Drukker A. · Guignard J.-P.
Division of Nephrology, Department of Pediatrics, University Medical Centre, Lausanne, Switzerland

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 2/26/1999

Number of Print Pages: 5
Number of Figures: 3
Number of Tables: 2

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: http://www.karger.com/NEF

Abstract

We performed renal function tests in 18 young patients, 1.8–14.6 years of age, with cyanotic congenital heart disease (CCHD). Glomerular filtration rate was normal (116 ± 4.5 ml/min/1.73 m2), and renal plasma flow was decreased (410 ± 25 ml/min/1.73 m2) with a rise in the filtration fraction (29 ± 1.1%). The suggested pathophysiologic explanation of these findings is that the blood hyperviscosity seen in patients with CCHD causes an overall increase in renal vascular resistance with a rise in intraglomerular blood pressure. Despite a sluggish flow of blood in the glomerular capillary bed, the effective filtration pressure was adjusted to conserve the glomerular filtration rate. In addition to these renal hemodynamic parameters, we also studied renal acidification and tubular sodium and water handling during a forced water diuresis. Our data indicate that children with CCHD have a mild to moderate normal ion gap metabolic acidosis due to a low proximal tubular threshold for bicarbonate. Proximal tubular sodium and water reabsorption under these conditions were somewhat increased, though not significantly, probably due to intrarenal hydrostatic forces, in particular the rise in the oncotic pressure in the postglomerular capillaries in patients with high hematocrit values. The distal tubular functions such as sodium handling and acidification were not affected.


  

Author Contacts

Prof. Jean-Pierre Guignard
Unité de Néphrologie, Département de Pédiatrie
Centre Hospitalier Universitaire Vaudois (CHUV), CH–1011 Lausanne (Switzerland)
Tel. +41 21 314 35 69, Fax +41 21 314 36 26
E-Mail Jean-Pierre.Guignard@chuv.hosdpvd.ch

  

Article Information

Accepted: October 6, 1998
Number of Print Pages : 5
Number of Figures : 3, Number of Tables : 2, Number of References : 23

  

Publication Details

Nephron
Founded 1964 by G. Richet and G.E. Schreiner

Vol. 81, No. 3, Year 1999 (Cover Date: March 1999)

Journal Editor: G.M. Berlyne, Brooklyn, N.Y.; S. Giovannetti, Pisa
ISSN: 0028–2766 (print), 1423–0186 (Online)

For additional information: http://www.karger.com/journals/nef


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: 2/26/1999

Number of Print Pages: 5
Number of Figures: 3
Number of Tables: 2

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: http://www.karger.com/NEF


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