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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: sadohehi@yahoo.com; ehidiamen.sadoh@uniben.edu
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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.

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