Related Experiment Video

Updated: May 24, 2026

A Mouse 5/6th Nephrectomy Model That Induces Experimental Uremic Cardiomyopathy
07:52

A Mouse 5/6th Nephrectomy Model That Induces Experimental Uremic Cardiomyopathy

Published on: November 7, 2017

Early cardiac dysfunction in pediatric patients on maintenance dialysis and post kidney transplant

Rossana Malatesta-Muncher1, Janaka Wansapura, Michael Taylor

  • 1Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 7022, Cincinnati, OH 45229, USA.

Pediatric Nephrology (Berlin, Germany)
|February 24, 2012
PubMed

Insights

Children with advanced chronic kidney disease (CKD) show early cardiac changes, including impaired myocardial strain and energy metabolism, even with normal ejection fraction (EF). These abnormalities are linked to increased left ventricular mass, suggesting maladaptive hypertrophy.

Area of Science:

  • Cardiology
  • Nephrology
  • Biochemistry

Background:

  • Children with advanced chronic kidney disease (CKD) often develop left ventricular (LV) hypertrophy.
  • The threshold of hypertrophy leading to cardiac dysfunction in pediatric CKD is not well understood.
  • Systolic function, typically assessed by ejection fraction (EF), is usually maintained in these patients, masking early cardiac changes.

Purpose of the Study:

  • To investigate early cardiac dysfunction markers in young patients with advanced CKD.
  • To utilize cardiac magnetic resonance (CMR) and phosphorus-31 MR spectroscopy (31P MRS) for assessing cardiac function and energy metabolism.
  • To compare findings in dialysis and post-transplant pediatric CKD patients with healthy controls.

Main Methods:

  • Cardiac magnetic resonance (CMR) and phosphorus-31 MR spectroscopy (31P MRS) were employed.
  • Evaluated outcomes included peak LV myocardial circumferential strain (Ecc), myocardial T2 relaxation time, T2 distribution full width at half maximum (FWHM), and phosphocreatinine/adenosine triphosphate (PCr/ATP) ratio.
  • Ten dialysis patients, ten post-transplant patients, and healthy controls participated.

Main Results:

  • All patients exhibited normal ejection fraction (EF); however, 45% had reduced circumferential strain (Ecc).
  • Dialysis patients showed significantly lower Ecc compared to transplant patients (p<0.0001).
  • Patients demonstrated elevated T2 relaxation times and FWHM (p=0.056, p=0.01), reduced PCr/ATP ratio (p=0.02), and these were correlated with increased left ventricular mass index (LVM index).

Conclusions:

  • Young patients with advanced CKD and preserved EF exhibit early signs of cardiac dysfunction.
  • These cardiac abnormalities, including reduced Ecc and altered energy metabolism, are associated with increased LVM index.
  • Findings suggest the development of maladaptive hypertrophy in pediatric CKD patients, even before overt systolic dysfunction is apparent.
Abstract

Related Concept Videos

Dialysis01:27

Dialysis

Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Dialysis01:15

Dialysis

Dialysis is a diffusion-based purification process that separates analyte molecules from a complex matrix. This is accomplished by allowing molecules in the solution to pass through a semipermeable membrane into a liquid on the other side. The membrane is usually made of cellulose acetate or cellulose nitrate, and the second liquid must be miscible with the solution. Ions (e.g., chloride or sodium) or organic molecules (e.g., glucose) can pass through the membrane pores, which generally have...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...
Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...