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Left ventricular systolic and diastolic function and carotid intima-media thickness in pediatric dialysis patients
Mahmut Civilibal1, Huseyin Oflaz, Salim Caliskan
1Department of Pediatric Nephrology, Istanbul University Cerrahpasa Medical Faculty, Cerrahpasa, 34303 Istanbul, Turkey. drcivilibal@hotmail.com
Background:
Cardiovascular complications are common in patients with end-stage renal disease (ESRD). We aimed to investigate left ventricular (LV) function and carotid intima-media thickness (cIMT) in children and adolescents with ESRD.
Methods:
This study included 38 ESRD patients (15 hemodialysis and 23 peritoneal dialysis) and 17 age- and sex-matched healthy subjects.
Results:
The ESRD patients had significantly lower mean mitral E/A ratio, and higher left ventricular mass index (LVMI) and cIMT than the control group. Compared with PD patients, HD patients had worse LV diastolic function. In stepwise linear regression analysis, LVMI (P = 0.043) and hemoglobin (P = 0.015) turned out to be independent variables for predicting diastolic dysfunction (reduced E/A ratio), and the only significant predictor of cIMT was indexed diastolic blood pressure (DBP) (P = 0.035).
Conclusion:
Cardiovascular structure and function abnormalities are also common in pediatric dialysis patients, as in adults. Furthermore our data indicated that hemodialysis was disadvantageous for preserving LV diastolic function as compared with peritoneal dialysis.
