Abstract 18079: Albuminuria in Adults With Congenital Heart Disease: Results From the Boston Adult Congenital Heart Biobank
Introduction: Albuminuria is present in ~5-10% of the population with a higher prevalence among those with diabetes mellitus or hypertension. Its presence reflects microvascular dysfunction and is associated with adverse outcomes. We assessed the prevalence of and risk factors for albuminuria in adults with congenital heart disease (CHD).
Methods: We enrolled outpatients with CHD ≥18 years old between 2012 and 2015 at Boston Children’s and Brigham and Women’s Hospitals. Urine creatinine and albumin were measured. Albuminuria was defined as an albumin to creatinine ratio (ACR) >30 mg/g; ACR >30-300 mg/g was classified as moderately increased albuminuria while values >300 mg/g were classified as severely increased albuminuria.
Results: A total of 575 patients with data on urine protein and creatinine were included. The most common types of CHD were left sided obstructive lesions (22.3%), tetralogy of Fallot (20.0%), single ventricle Fontan (16.8%), simple shunt lesions (16.6%) and transposition of the great arteries with a systemic right ventricle (9.6%). Albuminuria was present in 169 (29.4%), moderately increased in 141 (24.5%) and severely increased in 28 (4.9%). This was not attributable to the presence of diabetes mellitus or systemic hypertension. Albuminuria was associated with older age, BMI<30kg/m2, and worse functional class (Table). While albuminuria was most common among patients with cyanosis or a single ventricle Fontan circulation, it was still present in 23% of patients without either of these characteristics. Use of diuretics or beta-blockers was more common in those with albuminuria, but there was no difference in the use of angiotensin converting enzyme inhibitors or receptor blockers.
Conclusions: Adults with CHD have a high prevalence of albuminuria with the highest prevalence seen in patients with either cyanosis or a Fontan circulation. The mechanisms and clinical implications of this observation remain to be defined.
Author Disclosures: S. Rajpal: None. L. Alshawabkeh: None. J. Owumi: None. R. Bradley: None. E.I. Landzberg: None. M.N. Singh: None. M. Gurvitz: None. F.R. McCausland: None. S.S. Waikar: None. M.J. Landzberg: None. A.R. Opotowsky: None.
- © 2016 by American Heart Association, Inc.