Phenotyping of Fontan-Associated Renal Physiology and Disease
Abstract
Background: Kidney dysfunction is prevalent but insufficiently understood in Fontan patients. We aimed to investigate Fontan-Associated Renal Disease (FARD) through comprehensive phenotyping using biomarkers of renal function and injury, as well as ultrasound assessment of intrarenal hemodynamics.
Methods: We prospectively collected data on serum creatinine and cystatin C levels, and 24-h urine creatinine clearance and albumin excretion in 25 Fontan patients, comparing them to healthy age- and sex-matched controls. Additionally, we measured intrarenal venous and arterial flow patterns using Doppler ultrasonography.
Results: Median age was 28 (Q1-Q3: 19-35) years, with 48% female. Compared to controls, Fontan patients had similar creatinine-based eGFR (eGFRcr) (114 vs. 106 mL/min/1.73 m2; p = 0.2), lower cystatin C-based eGFR (eGFRcys) (96 vs. 106 mL/min/1.73 m2; p = 0.045), and lower 24-h urinary creatinine excretion (10.0 vs. 13.7 mmol/24 h; p cys and urine albumin correlated with age (r = -0.56 and r = 0.44, respectively; p < 0.05). Twenty--four out of 25 patients and all controls had continuous intrarenal venous flow patterns. Venous impedance and arterial renal resistance indices were higher in patients than controls (0.44 vs. 0.14 and 0.67 vs. 0.60, respectively; p < 0.05).
Conclusion: FARD involves a progressive decline in kidney function and glomerular injury. eGFRcr masks kidney dysfunction in Fontan patients due to reduced muscle mass. Fontan intrarenal hemodynamics…
Read the paper
Related studies
- Drug repositioning: a brief overview
- Cyclic nucleotide phosphodiesterases in Drosophila melanogaster
- Time-resolved in silico modeling of fine-tuned cAMP signaling in platelets: feedback loops, titrated phosphorylations and pharmacological modulation
- Current View on Green Tea Catechins Formulations, Their Interactions with Selected Drugs, and Prospective Applications for Various Health Conditions
- In silico Structure-based Identification of Novel Acetylcholinesterase Inhibitors Against Alzheimer’s Disease
- Development and In Vitro Evaluation of Controlled Release Viagra® Containing Poloxamer-188 Using Gastroplus™ PBPK Modeling Software for In Vivo Predictions and Pharmacokinetic Assessments
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.