Microalbuminuria in children with cyanotic congenital heart disease in Enugu, Nigeria; a comparative study

Abstract

Background: Children with congenital heart diseases are at increased risk of developing chronic kidney disease (CKD) later in life, and children with cyanotic congenital heart disease (CCHD) are at greater risk. Objectives: This study aimed to determine the prevalence of microalbuminuria and the associations between microalbuminuria and age, oxygen saturation and haematocrit in children with cyanotic congenital heart disease. Methods: This was a comparative, cross-sectional analytical study carried out over a period of six months. Thirty-six children with CCHD and thirty-six apparently healthy children were enrolled consecutively. Haematocrit levels, oxygen saturation, serum and urine creatinine levels and urine albumin levels were determined for eligible participants. A urine albumin/creatinine ratio in the range of 30–300 mg/g was classified as positive for microalbuminuria. Parametric and nonparametric tests were performed to determine the associations between the dependent and independent variables. Results: The prevalence rates of microalbuminuria were 38.9% (95% CI: 20.1, 56.5) and 5.6% (95% CI: 0.67, 18.7) in children with CCHD and in apparently healthy children, respectively. More children with CCHD than apparently healthy children had microalbuminuria. χ2 = 11.57, COR = 10.8 (95% CI: 2.23, 52.29), p = 0.001. Compared with those without microalbuminuria, children with microalbuminuria had significantly higher haematocrits. χ2 = 12.38, p = 0.001. Multivariate logistic regression revealed that a haematocrit ≥ 56% was a strong predictor of microalbuminuria in children with CCHD. AOR = 18.33 (95% CI: 2.52, 133.26), p = 0.004. Conclusion: This study demonstrated that children with CCHD are more likely to have microalbuminuria than are children who appear to be in good health and that microalbuminuria in this group of children is related to higher haematocrit levels. Early screening of this group of children is recommended to reduce the risk of progressive kidney disease. Clinical trial number: Not applicable.