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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
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Children with chronic renal disease undergoing dialysis or conservative treatment--differences in structural and

Valeska Tavares Scavarda, Aurelio Carvalho Pinheiro, Symône Damasceno Costa

    Echocardiography (Mount Kisco, N.Y.)
    |July 30, 2014
    PubMed

    Insights

    Children with chronic kidney disease (CKD) on dialysis (DI) experience more cardiac issues, including hypertension and left ventricular hypertrophy (LVH), than those on conservative treatment (CT). Cardiovascular events were also more frequent in the DI group.

    Area of Science:

    • Pediatric Nephrology
    • Cardiology
    • Clinical Medicine

    Background:

    • Cardiac disease is a common complication in children with chronic kidney disease (CKD).
    • Cardiac involvement is well-documented in pediatric CKD patients on dialysis (DI).
    • Cardiac involvement in pediatric CKD patients on conservative treatment (CT) is less understood.

    Purpose of the Study:

    • To compare cardiac involvement in children with CKD undergoing DI versus CT.
    • To analyze cardiac structural and functional changes using echocardiography.
    • To identify factors associated with cardiac abnormalities in pediatric CKD.

    Main Methods:

    • Echocardiography was used to assess cardiac variables in 71 children with CKD (41 DI, 30 CT) and 33 controls.
    • Measurements included arterial pressure, left ventricular geometry, ejection fraction, and diastolic function.
    • Children were followed for 18 months, with statistical analysis using comparison and regression tests (P < 0.05).

    Main Results:

    • Hypertension (AH) was more prevalent in DI (65.8%) than CT (33.3%) children.
    • Abnormal left ventricular geometric patterns, including left ventricular hypertrophy (LVH), were significantly higher in DI (90.3%) compared to CT (46.7%).
    • Diastolic function alteration (DFA) was more common in DI (68.3%) than CT (33.3%) patients. DI and AH were associated with LVH.

    Conclusions:

    • Children with CKD on conservative treatment (CT) exhibit less cardiac involvement than those on dialysis (DI).
    • Left ventricular hypertrophy (LVH) in pediatric CKD is associated with both dialysis treatment and arterial hypertension (AH).
    • A significant proportion of children on DI experienced cardiovascular events during the follow-up period.
    Abstract

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