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Predictors of left ventricular hypertrophy in children on chronic peritoneal dialysis

Zelal Bircan1, Ali Duzova, Nilgun Cakar

  • 1Pediatric Nephrology, Kocaeli University School of Medicine, Kocaeli, Turkey.

Pediatric Nephrology (Berlin, Germany)
|March 19, 2010
PubMed

Insights

Left ventricular hypertrophy (LVH) is common in children on chronic peritoneal dialysis (CPD). Maintaining hematocrit above 31% and daytime systolic blood pressure load below 15% may prevent LVH progression.

Area of Science:

  • Pediatric Nephrology
  • Cardiology
  • Hypertension

Background:

  • Conflicting data exists on blood pressure and left ventricular hypertrophy (LVH) in pediatric chronic renal failure.
  • Ambulatory blood pressure monitoring (ABPM) and hematological parameters require further investigation for LVH prediction in children on chronic peritoneal dialysis (CPD).

Purpose of the Study:

  • To evaluate the predictive value of ABPM and hematological/biochemical markers for LVH in children undergoing CPD.
  • To identify key factors for preventing LVH progression in this population.

Main Methods:

  • Echocardiography and 24-hour ABPM were performed in 47 children on CPD.
  • Routine biochemical and hematological tests were conducted.
  • Stepwise multiple regression analysis identified independent predictors of LVH.

Main Results:

  • LVH was prevalent, affecting 70.2% of children on CPD.
  • Daytime systolic and diastolic blood pressure values from ABPM were significantly higher than casual readings.
  • Daytime systolic blood pressure load and hematocrit were independent predictors of LVH.

Conclusions:

  • LVH is highly prevalent in children on CPD.
  • A hematocrit level >31% and daytime systolic blood pressure load <15% are associated with a lower risk of LVH.
  • Targeting these parameters may help prevent LVH progression in children on CPD.

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