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Abnormal left ventricular mass and aortic distensibility in pediatric dialysis patients

Renee F Robinson1, Milap C Nahata, Elizabeth Sparks

  • 1Children's Research Institute, 700 Children's Drive, Columbus, OH 43205, USA. Robinsonr@pediatrics.ohio-state.edu

Pediatric Nephrology (Berlin, Germany)
|November 2, 2004
PubMed

Insights

Children with end-stage renal disease (ESRD) show cardiovascular damage, including increased left ventricular mass (LVM) and abnormal aortic distensibility (AD). Hemodialysis (HD) patients had greater vascular stiffness than peritoneal dialysis (PD) patients.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Research
  • Renal Disease Pathophysiology

Background:

  • Cardiovascular disease (CVD) is a major concern in end-stage renal disease (ESRD).
  • Pathophysiological processes affecting cardiovascular function in adult ESRD patients are also present in pediatric ESRD.
  • Established correlations between left ventricular mass (LVM) and aortic distensibility (AD) in adult hemodialysis (HD) patients are not well-defined in pediatric populations.

Purpose of the Study:

  • To investigate cardiovascular damage, specifically LVM and AD, in pediatric ESRD patients undergoing HD or peritoneal dialysis (PD).
  • To analyze the relationship between AD, LVM, LVMI, blood pressure (BP), and demographic factors in pediatric ESRD patients.
  • To compare cardiovascular parameters between children on HD and PD.

Main Methods:

  • Retrospective study analyzing LVM, LVMI, and AD in pediatric ESRD patients (n=9 HD, n=9 PD) and a control group.
  • Comparison of cardiovascular parameters between dialysis modalities and a control population.
  • Analysis of correlations between AD, LVM, LVMI, pre-dialysis and post-dialysis BP, and demographic factors.

Main Results:

  • Both LVM and AD were significantly higher in the dialysis population compared to controls.
  • LVM and LVMI did not differ significantly between HD and PD groups.
  • Aortic distensibility (AD) was significantly lower in the HD group compared to the PD group, indicating greater vascular stiffness in HD patients.

Conclusions:

  • Pediatric ESRD patients on dialysis exhibit increased LVM and abnormal vascular stiffness (reduced AD).
  • Vascular stiffness is more pronounced in children undergoing HD compared to PD.
  • Further research is needed to understand the impact of BP control, uremia, and other factors on these cardiovascular abnormalities in pediatric ESRD.

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