Creatinine versus cystatin C to estimate glomerular filtration rate in adults with congenital heart disease: Results of the Boston Adult Congenital Heart Disease Biobank.


Journal

American heart journal
ISSN: 1097-6744
Titre abrégé: Am Heart J
Pays: United States
ID NLM: 0370465

Informations de publication

Date de publication:
08 2019
Historique:
received: 23 12 2018
accepted: 26 04 2019
pubmed: 17 6 2019
medline: 7 3 2020
entrez: 17 6 2019
Statut: ppublish

Résumé

Glomerular filtration rate is a key physiologic variable with a central role in clinical decision making and a strong association with prognosis in diverse populations. Reduced estimated glomerular filtration rate (eGFR) is common among adults with congenital heart disease (ACHD). We conducted a prospective cohort study of outpatient ACHD ≥18 years old seen in 2012-2017. Creatinine and cystatin C were measured; eGFR was calculated using either the creatinine or cystatin C Chronic Kidney Disease-Epidemiology Collaboration equation (CKD-EPI Our cohort included 911 ACHD (39 ± 14 years old, 49% female). Mean CKD-EPI Cystatin C-based eGFR more strongly predicts clinical events than creatinine-based eGFR in ACHD. Creatinine-based methods appear particularly questionable in the Fontan circulation.

Sections du résumé

BACKGROUND
Glomerular filtration rate is a key physiologic variable with a central role in clinical decision making and a strong association with prognosis in diverse populations. Reduced estimated glomerular filtration rate (eGFR) is common among adults with congenital heart disease (ACHD).
METHODS
We conducted a prospective cohort study of outpatient ACHD ≥18 years old seen in 2012-2017. Creatinine and cystatin C were measured; eGFR was calculated using either the creatinine or cystatin C Chronic Kidney Disease-Epidemiology Collaboration equation (CKD-EPI
RESULTS
Our cohort included 911 ACHD (39 ± 14 years old, 49% female). Mean CKD-EPI
CONCLUSIONS
Cystatin C-based eGFR more strongly predicts clinical events than creatinine-based eGFR in ACHD. Creatinine-based methods appear particularly questionable in the Fontan circulation.

Identifiants

pubmed: 31203159
pii: S0002-8703(19)30107-3
doi: 10.1016/j.ahj.2019.04.018
pii:
doi:

Substances chimiques

Biomarkers 0
Cystatin C 0
Creatinine AYI8EX34EU

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

142-155

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Alexander R Opotowsky (AR)

Department of Cardiology, Boston Children's Hospital, Boston, MA, United States; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA. Electronic address: alexander.opotowsky@cardio.chboston.org.

Matthew Carazo (M)

Department of Cardiology, Boston Children's Hospital, Boston, MA, United States; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.

Michael N Singh (MN)

Department of Cardiology, Boston Children's Hospital, Boston, MA, United States; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.

Konstantinos Dimopoulos (K)

Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College of Science and Medicine, London, United Kingdom.

David A Cardona-Estrada (DA)

Department of Medicine, North Shore Medical Center, Salem, MA, USA.

Ahmed Elantably (A)

Department of Medicine, North Shore Medical Center, Salem, MA, USA.

Sushrut S Waikar (SS)

Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.

Finnian R Mc Causland (FR)

Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.

Gruschen Veldtman (G)

Adolescent and Adult Congenital Heart Disease Program, Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Jasmine Grewal (J)

Pacific Adult Congenital Heart Disease Clinic, Division of Cardiology, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.

Catherine Gray (C)

Department of Cardiology, Boston Children's Hospital, Boston, MA, United States.

Brittani N Loukas (BN)

Department of Cardiology, Boston Children's Hospital, Boston, MA, United States.

Saurabh Rajpal (S)

Ohio State University Division of Cardiovascular Medicine and Nationwide Children's Hospital Heart Center, Columbus, OH, USA.

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Classifications MeSH