Long-Term Kidney Function After the Fontan Operation: JACC Review Topic of the Week

J Am Coll Cardiol. 2020 Jul 21;76(3):334-341. doi: 10.1016/j.jacc.2020.05.042.

Abstract

The Fontan procedure has improved survival and quality of life for patients with single ventricle physiology. Along with extended life expectancy comes a growing population that is experiencing long-term multiorgan adverse effects. Whereas cardiorenal interactions have been extensively studied in patients with a structurally normal heart, these are less well understood in patients with a single ventricle. Several studies have investigated the prevalence of reduced glomerular filtration rate and albuminuria in the Fontan population; however, the long-term implication of renal dysfunction is not well established in this population. This paper provides a concise review of the published reports on the pathophysiology and spectrum of Fontan-associated renal disease. It also identifies gaps in currently available evidence that can guide ongoing and future research.

Keywords: Fontan; chronic kidney disease; cystatin C; renal resistive index.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cardiology*
  • Fontan Procedure / methods*
  • Glomerular Filtration Rate / physiology*
  • Heart Defects, Congenital / surgery*
  • Humans
  • Periodicals as Topic*
  • Quality of Life*
  • Renal Insufficiency / physiopathology*