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Evaluation of renal injury in children with uncorrected CHDs with significant shunt using urinary neutrophil gelatinase-associated lipocalin

Published online by Cambridge University Press:  03 August 2020

Promise Monday ,
Nosakhare J. Idouriyekemwen  and
Wilson E. Sadoh Open the ORCID record for Wilson E. Sadoh [Opens in a new window]
Promise Monday
Affiliation:
Department of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria Mid & South Essex NHS Foundation Trust, Broomfield Hospital, Court Road, Chelmsford, Essex CM1 7ET, UK
Nosakhare J. Idouriyekemwen
Affiliation:
Department of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria
Wilson E. Sadoh*
Affiliation:
Department of Child Health, University of Benin Teaching Hospital, Benin City, Nigeria
*
Author for correspondence: W. E. Sadoh, FWACP, FACC, Department of Child Health/Paediatrics, University of Benin Teaching Hospital, PMB 1111, Benin City, Nigeria. Tel: +2348028809710. E-mail: [email protected]; [email protected]
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Abstract

Background:

CHDs can be complicated by renal injury which worsens morbidity and mortality. Urinary neutrophil gelatinase-associated lipocalin, a sensitive and specific biomarker of renal tubular injury, has not been studied in children with uncorrected CHDs. This study evaluated renal injury in children with uncorrected CHDs using this biomarker.

Methods:

The patients were children with uncorrected CHDs with significant shunt confirmed on echocardiogram with normal renal ultrasound scan, in the paediatric cardiology clinic of a tertiary hospital. The controls were age-matched healthy children recruited from general practice clinics. Information on bio-data and socio-demographics were collected and urine was obtained for measurement of urinary neutrophil gelatinase-associated lipocalin levels.

Results:

A total of 65 children with uncorrected CHDs aged 2 to 204 months were recruited. Thirty-one (47.7%) were males while 36 (55.4%) had acyanotic CHDs. The median urinary neutrophil gelatinase-associated lipocalin level of patients of 26.10 ng/ml was significantly higher than controls of 16.90 ng/ml (U = 1624.50, p = 0.023). The median urinary neutrophil gelatinase-associated lipocalin level of patients with cyanotic and acyanotic CHDs were 30.2 ng/ml and 22.60 ng/ml respectively; (Mann–Whitney U = 368.50, p = 0.116). The prevalence of renal injury using 95th percentile cut-off value of urinary neutrophil gelatinase-associated lipocalin was 16.9%. Median age of patients with renalinjury was 16 (4–44) months.

Conclusions:

Children with uncorrected CHDs have renal injury detected as early as infancy. The use of urinary neutrophil gelatinase-associated lipocalin in early detection of renal injury in these children may enhance early intervention and resultant prevention of morbidity and reduction in mortality.

Keywords

UncorrectedCHDsurinary neutrophil gelatinase-associated lipocalinchildrenrenal functionrenal injury
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 9 , September 2020 , pp. 1313 - 1320
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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Footnotes

Contributions: (I) Conception and design: All authors; (II) Administrative support: WE Sadoh, NJ Iduoriyekemwen; (III) Provision of study materials and patients: P Monday, WE Sadoh; (IV) Collection and assembly of data: P Monday; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

References

Abdulla, R. Tetralogy of Fallot; Essential Paediatric Cardiology. In: Koenig, P, Hijazid, ZM, Zimmerman, F. (eds). The McGraw-Hill companies, Inc, New York. 2004: 193–198.Google Scholar
Linde, DV, Konings, EM, Slager, MA, et al.Birth Prevalence of Congenital Heart Disease Worldwide: A Systematic Review and Meta-Analysis. J Am Coll Cardiol. 2011; 58: 2241–2247.CrossRefGoogle ScholarPubMed
Gupta, B, Antia, AU. Incidence of congenital heart disease in Nigerian children. Brit heart J. 1967; 29: 906–909.CrossRefGoogle ScholarPubMed
Chinawa, JM, Obu, H A, Eke, CB, Eze, JC. Pattern and clinical profile of children with complex cardiac anomaly at University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria. Niger J Clin Pract. 2013; 16: 462–467.CrossRefGoogle ScholarPubMed
Ibadin, MO, Sadoh, WE, Osarogiagbon, W. Congenital heart diseases at the university of Benin teaching hospital. Niger J Paediatr. 2005; 32: 29–32.Google Scholar
Sadoh, WE, Uzodimma, CC, Daniels, Q. Congenital Heart Disease in Nigerian Children: a multicenter echocardiographic study. World Journal for Pediatric and Congenital Heart Surgery. 2013; 4: 172–176.CrossRefGoogle ScholarPubMed
Ekure, EN, Bode-Thomas, F, Sadoh, WE, et al.Congenital Heart Defects in Nigerian Children: Preliminary Data from the National Paediatric Cardiac Registry. World Journal for Paediatric and Congenital Heart Surgery. 2017; 8: 699–706.CrossRefGoogle ScholarPubMed
Otaigbe, BE, Tabansi, PN. Congenital heart disease in the Niger Delta region of Nigeria: a four-year prospective echocardiographic analysis. Cardiovasc J Afr. 2014; 25: 265–268.CrossRefGoogle ScholarPubMed
Sadoh, WE, Nwaneri, DU, Owobu, AC. The cost of out-patient management of chronic heart failure in children with congenital heart disease. Niger J Clin Pract. 2011; 14: 65–69.CrossRefGoogle ScholarPubMed
Ekure, EN, Sadoh, WE, Bode-Thomas, F, et al.Audit of availability and distribution of paediatric cardiology services and facilities in Nigeria. Cardiovasc J Afr. 2016; 28: 54–59.CrossRefGoogle ScholarPubMed
Dimopoulos, K, Diller, GP, Koltsida, E, et al.Prevalence, predictors, and prognostic value of renal dysfunction in adults with congenital heart disease. Circulation. 2008; 117: 2311–2328.CrossRefGoogle ScholarPubMed
Perloff, JK. Systemic complications of cyanosis in adults with congenital heart disease – hematologic derangements, renal function, and urate metabolism. Cardiol Clin. 1993; 11: 689–699.CrossRefGoogle ScholarPubMed
Amoozgar, H, Basiratnia, M, Ghasemi, F. Renal Function in Children with Cyanotic Congenital Heart Disease: pre- and post-cardiac surgery evaluation. Iranian J Pediatr. 2014; 24: 81–86.Google ScholarPubMed
Maleki, M, Ghaffari, S, Ghaffari, MR, Samadi, M, Maleki, BRP, Behnam, S. Proteinuria in Congenital Heart Disease: is it a real problem? J CardiovascThorac Res. 2011; 3: 17–21.Google Scholar
Agras, PI, Derbent, M, Ozcay, F, et al.Effect of congenital heart disease on renal function in childhood. Nephron Physiol. 2005; 99(1): 10–15.CrossRefGoogle ScholarPubMed
Akita, H, Matsuoka, S, Kuroda, Y. Nephropathy in patients with cyanotic congenital heart disease. Tokushima J Exp Med. 1993; 40: 47–53.Google ScholarPubMed
Perloff, JK, Latta, H, Barsotti, P. Pathogenesis of the glomerular abnormality in cyanotic congenital heart disease. Am J Cardiol. 2000; 86: 1198–1204.CrossRefGoogle ScholarPubMed
National Kidney Foundation. Kidney Disease Outcomes Quality Initiative (K/DOQI) clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002; 39: S1–S266.Google Scholar
Zheng, J, Yao, Y, Han, L, Xiao, Y. Renal function and injury in infants and young children with congenital heart disease. Pediatr Nephrol. 2013; 28: 99–104.CrossRefGoogle ScholarPubMed
Saweirs, WW, Goddard, J. What are the best treatments for early chronic kidney disease? A background paper prepared for UK concensus Conference on early chronic kidney disease. Nephrol Dial Transplant. 2007; 22: 31–38.CrossRefGoogle Scholar
Devarajan, P. Emerging biomarkers of acute kidney injury. Contrib Nephrol. 2007; 156: 203–212.CrossRefGoogle ScholarPubMed
Mitsnefes, MM, Kathman, TS, Mishra, J, et al.Serum Neutrophil gelatinase-associated lipocalin as a marker of renal function in children with chronic kidney disease. Paediatr Nephrol. 2007; 22: 101–108.CrossRefGoogle ScholarPubMed
Mishra, J, Dent, C, Tarabishi, R, et al.Neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for acute renal injury after cardiac surgery. Lancet. 2005; 365: 1231–1238.CrossRefGoogle ScholarPubMed
Bolignano, D, Lacquaniti, A, Coppolino, G, et al.Neutrophil gelatinase-associated lipocalin (NGAL) and progression of chronic kidney disease. Clin J Am Soc Nephrol. 2009; 4: 337–344.CrossRefGoogle ScholarPubMed
Yamane, T. Statistics: An Introductory Analysis. 2nd edn. Harper and Row, New York, 1967.Google Scholar
Olusanya, O, Okpere, E, Ezimokhai, M. The importance of social class in voluntary fertility control in a developing country. West Afr J Med. 1985; 4: 205–212.Google Scholar
Amerian Society of Echocardiography. Recommendations for continous quality improvement in echocardiography. J Am Soc Echocardiogr. 1995; 8: S1–S28.Google Scholar
Grenier, FC, Ali, S, Syed, H, et al.Evaluation of the ARCHITECT urine NGAL assay: assay performance, specimen handling requirements and biological variability. Clin Biochem. 2010; 43: 615–620.CrossRefGoogle ScholarPubMed
Van de Vrie, M, Deegens, JK, Van der Vlag, J, Hilbrands, LB. Effect of Long term storage of urine samples on measurement of kidney injury molecule 1 (kim-1) and neutrophil gelatinase-asscociated lipocalin (NGAL). Am J Kidney Dis. 2014; 63: 573–576.CrossRefGoogle Scholar
Pedersen, KR, Ravn, HB, Hjortdal, VE, Nørregaard, R, Povlsen, JV. Neutrophil gelatinase associated lipocalin (NGAL): validation of commercially available ELISA. Scand J Clin Lab Invest. 2010; 70: 374–382.CrossRefGoogle ScholarPubMed
Bennett, MR, Nehus, E, Haffner, C, Ma, Q, Devarajan, P. Paediatric reference ranges for acute kidney injury biomarkers. Pediatr Nephrol. 2015; 30: 677–685.CrossRefGoogle Scholar
Noori, NM, Sadeghi, S, Shahramian, I, Keshavarz, K. Urine β 2-Microglobolin in the Patients with Congenital Heart Disease. Int Cardiovasc Res J. 2013; 7: 62–66.Google ScholarPubMed
Mishra, J, Ma, Q, Kelly, C, et al.Kidney NGAL is a novel early marker of acute injury following transplantation. Paediatr Nephrol. 2006; 21: 856–863.CrossRefGoogle ScholarPubMed
Bennett, M, Dent, CL, Ma, Q, et al.Urine NGAL predicts severity of Acute Kidney Injury after Cardiac Surgery: a prospective study. J Am Soc Nephrol. 2008; 3: 665–673.CrossRefGoogle ScholarPubMed
Cangemi, G, Storti, SI, Cantinotti, MA, et al.Reference values for urinary neutrophil gelatinase-associated lipocalin (NGAL) in paediatric age measured with a fully automated chemiluminescent platform. Clin Chem Lab Med. 2013; 51: 1101–1105.CrossRefGoogle Scholar
Devarajan, P. The use of targeted biomarkers for chronic kidney disease. Adv Chronic Kidney Dis. 2010; 17: 469–479.CrossRefGoogle ScholarPubMed
Swagata, M, D’Souza, JLP. Anthropometric profiles of children with congenital heart disease. Int J Paediatr Res. 2016; 3: 577–583.Google Scholar
Varan, B, Tokel, K, Yilmaz, G. Malnutrition and growth failure in cyanotic and acyanotic congenital heart disease with and without pulmonary hypertension. Arch Dis Chil. 1999; 81: 49–52.CrossRefGoogle ScholarPubMed
Rahman, MA, Utamayasa, IKA, Hidayat, Tq, Irawan, R, Elizabeth, R. Anthropometric profile of children with cyanotic and noncyanotic congenital heart disease. Media Gizi Indonesia. 2020; 15: 1–6.CrossRefGoogle Scholar