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Updated: Apr 8, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Assessment of left ventricular function by tissue Doppler echocardiography in pediatric chronic kidney disease
Cagla Serpil Dogan1, Sema Akman1, Ayse Simsek2
1a Division of Pediatric Nephrology , University of Akdeniz , Antalya , Turkey .
Insights
Cardiovascular disease is a major concern in chronic kidney disease (CKD). This study found left ventricular hypertrophy and diastolic dysfunction in pediatric CKD patients, with anemia being a key predictor.
Area of Science:
- Pediatric Cardiology
- Nephrology
- Cardiovascular Research
Background:
- Cardiovascular disease is the leading cause of mortality in patients with chronic kidney disease (CKD).
- Early detection of cardiac abnormalities in pediatric CKD is crucial for management.
- Understanding the relationship between CKD progression and cardiac function is essential.
Purpose of the Study:
- To investigate the prevalence of left ventricular hypertrophy (LVH) and diastolic dysfunction in pediatric patients with CKD.
- To assess the correlation between estimated glomerular filtration rate (eGFR) and cardiac function parameters.
- To identify predictors of diastolic dysfunction in this population.
Main Methods:
- Cross-sectional study of 43 pediatric CKD patients, divided into two groups based on eGFR.
- Echocardiography, including conventional pulsed wave Doppler (cPWD) and tissue Doppler imaging (TDI), was performed.
- Diastolic function was assessed using early (E) and late (A) diastolic flow velocities, E' values, and E/E' ratios.
Main Results:
- Left ventricular hypertrophy (LVH) was present in 44.2% of patients.
- The E/E' ratio, indicative of diastolic dysfunction, was significantly higher in patients with lower eGFR and correlated positively with left ventricular mass index.
- Low hemoglobin levels were identified as an independent predictor of diastolic dysfunction (E/E' ratio).
Conclusions:
- Diastolic dysfunction and LVH are prevalent even in the early stages of pediatric CKD.
- Anemia is a significant risk factor and predictor of diastolic dysfunction in pediatric CKD.
- Addressing risk factors like anemia is critical for improving cardiovascular outcomes in children with CKD.
Background:
Cardiovascular (CV) disease remains the most common cause of mortality in chronic kidney disease (CKD).
Methods:
In this cross-sectional study, 43 pediatric patients with CKD were divided into two groups according to their estimated glomerular filtration rate (eGFR): groups 1 and 2 (eGR; 29-75 and 15-29 mL/min/1.73 m(2), respectively). M - mode, conventional pulsed wave Doppler (cPWD) echocardiography and tissue Doppler imaging (TDI) were performed in all patients and 16 healthy controls. Maximal early (E wave) and late (A wave) diastolic flow velocities were assessed by cPWD. Using TDI, the early (E') and late (A') diastolic filling velocities were recorded. Early and late diastoles were evaluated using E' values and E/E' ratios, respectively.
Results:
Left ventricular hypertrophy (LVH) was determined in 19/43 (44.2%) patients. The E/E' ratio was significantly higher in group 2 than in group 1 and controls. E/E' was found to be positively correlated with left ventricular mass (LVM) index, and negatively with hemoglobin (Hb) levels. Low Hb levels were only independent predictor of E/E' (p = 0.001, β: -0.470, 95% CI: -0.764; -0.196). E' ratio was significantly lower in both patient groups compared to the controls.
Conclusions:
LVH and diastolic dysfunction are already present in early stages of CKD. Treatment of risk factors, such as anemia, is important to improve the clinical outcome.
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