Central Venous Pressure and Impaired Renal Function in Children and Young Adults With Cardiovascular Disease

Authors

Jillian Olsen
Hari Tunuguntla
Alexander Alali
Swati Choudhry
Kyle D Hope
Kriti Puri
Joseph A Spinner
Ayse Akcan-Arikan
Jack F Price

Publication Date

7-1-2024

Journal

JACC: Advances

DOI

10.1016/j.jacadv.2024.100995

PMID

39129999

PMCID

PMC11312305

PubMedCentral® Posted Date

5-21-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

cardiorenal syndrome, central venous pressure, kidney injury, renal dysfunction

Abstract

BACKGROUND: Traditionally, low cardiac output has been considered the primary hemodynamic driver of renal function and injury. Adult data suggest that central venous pressure (CVP) is a more important factor.

OBJECTIVES: The authors hypothesized that in children with cardiovascular disease, higher CVP predicts lower estimated glomerular filtration rate (eGFR) and worsening renal function (WRF).

METHODS: We performed a single-center cohort study of patients aged 3 months to 21 years with biventricular circulation undergoing cardiac catheterization. Pearson's correlation and linear and Cox regression analyses were performed to determine associations with eGFR at the time of catheterization and WFR within 180 days after catheterization.

RESULTS: 312 patients had median age 7.9 years (IQR: 2.3 to 14.5 years), median eGFR 97 mL/min/1.73 m

CONCLUSIONS: Among children with a spectrum of cardiovascular disease, higher CVP is associated with lower eGFR and development of WRF, independent of cardiac index.