Renal Dysfunction is Common Among Adults After Palliation for Previous Tetralogy of Fallot
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Long-term survival after tetralogy of Fallot (TOF) repair is excellent. However, little is published regarding late noncardiac complications. This study aimed to determine the prevalence and risk factors for renal dysfunction among adults after TOF repair. For this study, 56 adult patients with complete repair of TOF were identified, and their charts were retrospectively reviewed. An estimated glomerular filtration rate (eGFR) for each patient was calculated using the Modification of Diet in Renal Disease formula (MDRD). Using each patient’s eGFR, he or she was classified into stages based on the National Kidney Foundation chronic kidney disease (CKD) staging. Clinical parameters were compared among patients with and those without renal dysfunction to identify risk factors for renal impairment. The median estimated eGFR rate for the cohort was 78 ml/min/1.73 m2. Based on the National Kidney Foundation CKD staging system, 54 % of the patients had at least stage 2 chronic renal disease. The risk factors identified were hypertension (p < 0.01), type 2 diabetes mellitus (p < 0.05), longer follow-up evaluation (p < 0.005), older age at complete repair (p < 0.05), and use of daily diuretics (p < 0.05). After repair of TOF, renal dysfunction is common at late follow-up evaluation. The study findings show the importance of routine assessment of renal function and the need to limit or avoid future episodes of acute kidney injury in this at-risk population.
KeywordsAdult congenital heart disease Renal function Tetralogy of Fallot
The authors gratefully acknowledge Mary Krolikowski for her support and guidance throughout this project. Funding was provided by the Medical College of Wisconsin.
Conflict of interest
No authors have any conflicts of interest to report.
- 6.Levey AS, Bosch JP, Breyer Lewis J et al (1999) A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Ann Intern Med 330:877–884Google Scholar
- 14.Sarnak MJ, Levey AS, Schoolwerth AC et al (2003) Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Hypertension 42:1050–1065PubMedCrossRefGoogle Scholar
- 17.Tutarel O, Denecke A, Bode-Boger SM, Martens-Lobenhoffer J, Schieffer B, Westhoff-Bleck M, Kielstein JT (2011) Symmetrical dimethylarginine outperforms CKD-EPI and MDRD-derived eGFR for the assessment of renal function in patients with adult congenital heart disease. Kidney Blood Press Res 34:41–45PubMedCrossRefGoogle Scholar