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Left ventricular hypertrophy and LV geometry in chronic dialysis children and adolescents
Adisorn Lumpaopong1, Chalermkiet Tuntrakool, Prapaipim Thirakhupt
1Pediatric Nephrology Division, Department of Pediatrics, Phramongkutklao Hospital, Bangkok, Thailand.
Insights
High blood pressure is common in children with end-stage renal disease (ESRD) and is linked to left ventricular hypertrophy (LVH). Monitoring blood pressure and LVH is crucial for preventing heart problems in these young patients.
Area of Science:
- Pediatric Nephrology
- Cardiology
- Internal Medicine
Background:
- Cardiovascular disease is a leading cause of mortality in end-stage renal disease (ESRD) patients.
- Left ventricular hypertrophy (LVH) is a known risk factor for cardiovascular events.
- Limited research exists on LVH prevalence and its correlates in pediatric chronic dialysis patients.
Purpose of the Study:
- To determine the prevalence of LVH in children undergoing chronic dialysis.
- To identify clinical and laboratory parameters correlated with left ventricular mass index (LVMI) in this population.
Main Methods:
- Retrospective review of 14 pediatric patients (11 hemodialysis, 3 peritoneal dialysis) at Phramongkutklao Hospital.
- Echocardiography was used to diagnose LVH and calculate LVMI.
- Clinical and laboratory data were analyzed to compare parameters between patients with and without LVH.
Main Results:
- The prevalence of LVH was 57% among the studied pediatric dialysis patients.
- Patients with LVH exhibited significantly higher systolic blood pressure (SBP) and diastolic blood pressure (DBP).
- Blood pressure showed a positive correlation, while patient age showed a negative correlation with LVMI.
Conclusions:
- Elevated blood pressure is significantly associated with left ventricular hypertrophy in pediatric chronic dialysis patients.
- Regular echocardiographic monitoring and long-term follow-up are recommended to mitigate cardiovascular risks.
- Early detection and management of hypertension are vital for preventing cardiovascular morbidity and mortality in this vulnerable group.
Abstract:
Data from USRDS and Thai Renal Replacement Therapy revealed cardiovascular disease is a common cause of death in ESRD patients. Left ventricular hypertrophy (LVH) is one of the risk factors however there are few studies about this in chronic dialysis children. In the present study, the authors retrospectively reviewed the prevalence of LVH and variable parameters correlated with LVMI in chronic dialysis patients in Phramongkutklao Hospital. Eleven hemodialysis and three peritoneal dialysis patients, aged 12.1 +/- 5 years, were included. LVH was diagnosed by calculating LVMI from echocardiographic study. Clinical and laboratory data were reviewed to compare parameters between LVH and without LVH groups. Prevalence of LVH was 57%. In the LVH group, 7 patients had eccentric LVH and 1 patient had concentric LVH. LVH patients had significantly high systolic BP (SBP), diastolic BP (DBP), index of SBP and index of DBP. Blood pressure also had positive correlation and patients age had negative correlation with LVMI. In conclusion, high blood pressure is associated with left ventricular hypertrophy. Serial echocardiography and long term follow up should be done in this patient group to prevent cardiovascular morbidity and mortality.
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