Prevalence, predictors, and outcomes of cardiorenal syndrome in children with dilated cardiomyopathy

a report from the Pediatric Cardiomyopathy Registry

Ahmad Kaddourah, Stuart L. Goldstein, Steven E. Lipshultz, James D. Wilkinson, Lynn A. Sleeper, Minmin Lu, Steven D. Colan, Jeffrey A. Towbin, Scott I. Aydin, Joseph Rossano, Melanie D. Everitt, Jeffrey G. Gossett, Paolo Rusconi, Paul F. Kantor, Rakesh K. Singh, John L. Jefferies

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: The association of cardiorenal syndrome (CRS) with mortality in children with dilated cardiomyopathy (DCM) is unknown. Methods: With a modified Schwartz formula, we estimated glomerular filtration rates (eGFR) for children ≥1 year of age with DCM enrolled in the Pediatric Cardiomyopathy Registry at the time of DCM diagnosis and annually thereafter. CRS was defined as an eGFR of 2. Children with and without CRS were compared on survival and serum creatinine concentrations (SCr). The association between eGFR and echocardiographic measures was assessed with linear mixed-effects regression models. Results: Of 285 eligible children with DCM diagnosed at ≥1 year of age, 93 were evaluable. CRS was identified in 57 of these 93 children (61.3 %). Mean (standard deviation) eGFR was 62.0 (22.6) mL/min/1.73 m2 for children with CRS and 108.0 (14.0) for those without (P <0.001); median SCr concentrations were 0.9 and 0.5 mg/dL, respectively (P <0.001). The mortality hazard ratio of children with CRS versus those with no CRS was 2.4 (95 % confidence interval 0.8–7.4). eGFR was positively correlated with measures of left ventricular function and negatively correlated with age. Conclusions: CRS in children newly diagnosed with DCM may be associated with higher 5-year mortality. Children with DCM, especially those with impaired left ventricular function, should be monitored for renal disease.

Original languageEnglish (US)
Pages (from-to)2177-2188
Number of pages12
JournalPediatric Nephrology
Volume30
Issue number12
DOIs
StatePublished - Jul 26 2015

Fingerprint

Cardio-Renal Syndrome
Dilated Cardiomyopathy
Cardiomyopathies
Registries
Pediatrics
Glomerular Filtration Rate
Left Ventricular Function
Creatinine
Child Mortality
Mortality
Serum
Confidence Intervals
Kidney

Keywords

  • Cardiomyopathy
  • Cardiorenal syndrome
  • Chronic kidney disease
  • Heart failure
  • Pediatrics

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

Kaddourah, A., Goldstein, S. L., Lipshultz, S. E., Wilkinson, J. D., Sleeper, L. A., Lu, M., ... Jefferies, J. L. (2015). Prevalence, predictors, and outcomes of cardiorenal syndrome in children with dilated cardiomyopathy: a report from the Pediatric Cardiomyopathy Registry. Pediatric Nephrology, 30(12), 2177-2188. https://doi.org/10.1007/s00467-015-3165-8

Prevalence, predictors, and outcomes of cardiorenal syndrome in children with dilated cardiomyopathy : a report from the Pediatric Cardiomyopathy Registry. / Kaddourah, Ahmad; Goldstein, Stuart L.; Lipshultz, Steven E.; Wilkinson, James D.; Sleeper, Lynn A.; Lu, Minmin; Colan, Steven D.; Towbin, Jeffrey A.; Aydin, Scott I.; Rossano, Joseph; Everitt, Melanie D.; Gossett, Jeffrey G.; Rusconi, Paolo; Kantor, Paul F.; Singh, Rakesh K.; Jefferies, John L.

In: Pediatric Nephrology, Vol. 30, No. 12, 26.07.2015, p. 2177-2188.

Research output: Contribution to journalArticle

Kaddourah, A, Goldstein, SL, Lipshultz, SE, Wilkinson, JD, Sleeper, LA, Lu, M, Colan, SD, Towbin, JA, Aydin, SI, Rossano, J, Everitt, MD, Gossett, JG, Rusconi, P, Kantor, PF, Singh, RK & Jefferies, JL 2015, 'Prevalence, predictors, and outcomes of cardiorenal syndrome in children with dilated cardiomyopathy: a report from the Pediatric Cardiomyopathy Registry', Pediatric Nephrology, vol. 30, no. 12, pp. 2177-2188. https://doi.org/10.1007/s00467-015-3165-8
Kaddourah, Ahmad ; Goldstein, Stuart L. ; Lipshultz, Steven E. ; Wilkinson, James D. ; Sleeper, Lynn A. ; Lu, Minmin ; Colan, Steven D. ; Towbin, Jeffrey A. ; Aydin, Scott I. ; Rossano, Joseph ; Everitt, Melanie D. ; Gossett, Jeffrey G. ; Rusconi, Paolo ; Kantor, Paul F. ; Singh, Rakesh K. ; Jefferies, John L. / Prevalence, predictors, and outcomes of cardiorenal syndrome in children with dilated cardiomyopathy : a report from the Pediatric Cardiomyopathy Registry. In: Pediatric Nephrology. 2015 ; Vol. 30, No. 12. pp. 2177-2188.
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abstract = "Background: The association of cardiorenal syndrome (CRS) with mortality in children with dilated cardiomyopathy (DCM) is unknown. Methods: With a modified Schwartz formula, we estimated glomerular filtration rates (eGFR) for children ≥1 year of age with DCM enrolled in the Pediatric Cardiomyopathy Registry at the time of DCM diagnosis and annually thereafter. CRS was defined as an eGFR of 2. Children with and without CRS were compared on survival and serum creatinine concentrations (SCr). The association between eGFR and echocardiographic measures was assessed with linear mixed-effects regression models. Results: Of 285 eligible children with DCM diagnosed at ≥1 year of age, 93 were evaluable. CRS was identified in 57 of these 93 children (61.3 {\%}). Mean (standard deviation) eGFR was 62.0 (22.6) mL/min/1.73 m2 for children with CRS and 108.0 (14.0) for those without (P <0.001); median SCr concentrations were 0.9 and 0.5 mg/dL, respectively (P <0.001). The mortality hazard ratio of children with CRS versus those with no CRS was 2.4 (95 {\%} confidence interval 0.8–7.4). eGFR was positively correlated with measures of left ventricular function and negatively correlated with age. Conclusions: CRS in children newly diagnosed with DCM may be associated with higher 5-year mortality. Children with DCM, especially those with impaired left ventricular function, should be monitored for renal disease.",
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T1 - Prevalence, predictors, and outcomes of cardiorenal syndrome in children with dilated cardiomyopathy

T2 - a report from the Pediatric Cardiomyopathy Registry

AU - Kaddourah, Ahmad

AU - Goldstein, Stuart L.

AU - Lipshultz, Steven E.

AU - Wilkinson, James D.

AU - Sleeper, Lynn A.

AU - Lu, Minmin

AU - Colan, Steven D.

AU - Towbin, Jeffrey A.

AU - Aydin, Scott I.

AU - Rossano, Joseph

AU - Everitt, Melanie D.

AU - Gossett, Jeffrey G.

AU - Rusconi, Paolo

AU - Kantor, Paul F.

AU - Singh, Rakesh K.

AU - Jefferies, John L.

PY - 2015/7/26

Y1 - 2015/7/26

N2 - Background: The association of cardiorenal syndrome (CRS) with mortality in children with dilated cardiomyopathy (DCM) is unknown. Methods: With a modified Schwartz formula, we estimated glomerular filtration rates (eGFR) for children ≥1 year of age with DCM enrolled in the Pediatric Cardiomyopathy Registry at the time of DCM diagnosis and annually thereafter. CRS was defined as an eGFR of 2. Children with and without CRS were compared on survival and serum creatinine concentrations (SCr). The association between eGFR and echocardiographic measures was assessed with linear mixed-effects regression models. Results: Of 285 eligible children with DCM diagnosed at ≥1 year of age, 93 were evaluable. CRS was identified in 57 of these 93 children (61.3 %). Mean (standard deviation) eGFR was 62.0 (22.6) mL/min/1.73 m2 for children with CRS and 108.0 (14.0) for those without (P <0.001); median SCr concentrations were 0.9 and 0.5 mg/dL, respectively (P <0.001). The mortality hazard ratio of children with CRS versus those with no CRS was 2.4 (95 % confidence interval 0.8–7.4). eGFR was positively correlated with measures of left ventricular function and negatively correlated with age. Conclusions: CRS in children newly diagnosed with DCM may be associated with higher 5-year mortality. Children with DCM, especially those with impaired left ventricular function, should be monitored for renal disease.

AB - Background: The association of cardiorenal syndrome (CRS) with mortality in children with dilated cardiomyopathy (DCM) is unknown. Methods: With a modified Schwartz formula, we estimated glomerular filtration rates (eGFR) for children ≥1 year of age with DCM enrolled in the Pediatric Cardiomyopathy Registry at the time of DCM diagnosis and annually thereafter. CRS was defined as an eGFR of 2. Children with and without CRS were compared on survival and serum creatinine concentrations (SCr). The association between eGFR and echocardiographic measures was assessed with linear mixed-effects regression models. Results: Of 285 eligible children with DCM diagnosed at ≥1 year of age, 93 were evaluable. CRS was identified in 57 of these 93 children (61.3 %). Mean (standard deviation) eGFR was 62.0 (22.6) mL/min/1.73 m2 for children with CRS and 108.0 (14.0) for those without (P <0.001); median SCr concentrations were 0.9 and 0.5 mg/dL, respectively (P <0.001). The mortality hazard ratio of children with CRS versus those with no CRS was 2.4 (95 % confidence interval 0.8–7.4). eGFR was positively correlated with measures of left ventricular function and negatively correlated with age. Conclusions: CRS in children newly diagnosed with DCM may be associated with higher 5-year mortality. Children with DCM, especially those with impaired left ventricular function, should be monitored for renal disease.

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KW - Cardiorenal syndrome

KW - Chronic kidney disease

KW - Heart failure

KW - Pediatrics

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