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[Cardiovascular disease in pediatric patients under chronic peritoneal dialysis]
Paula Lehmann F1, Francisco Cano Sc2
1Subdepartamento de Pediatría, Hospital Base Valdivia, Facultad de Medicina, Universidad Austral de Chile, Chile.
Insights
Pediatric patients on peritoneal dialysis (PD) often have severe left ventricular hypertrophy (LVH), indicating high cardiovascular risk. Blood pressure and ultrafiltration significantly correlate with LVH in this vulnerable group.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Health in Chronic Kidney Disease
- Renal Replacement Therapy
Background:
- Peritoneal dialysis (PD) is a primary renal replacement therapy for pediatric end-stage renal disease.
- This population faces a significantly elevated mortality rate, primarily due to cardiovascular complications.
Purpose of the Study:
- To assess cardiovascular outcomes in pediatric patients undergoing chronic PD.
- To characterize patients on PD concerning dialysis adequacy and cardiovascular health.
Main Methods:
- A cross-sectional study involving pediatric patients on stable PD.
- Collected epidemiological, dialytic, biochemical, and cardiovascular data.
- Calculated Left Ventricular Mass Index (LVMI) to diagnose Left Ventricular Hypertrophy (LVH).
Main Results:
- 52% of the 21 pediatric patients exhibited LVH, with 91% of those cases being severe LVH.
- Significant correlations were found between ultrafiltration/m2 and systolic blood pressure.
- Left ventricular mass index showed a significant relationship with hemoglobin levels.
Conclusions:
- The high prevalence of severe LVH underscores increased cardiovascular risk in pediatric PD patients.
- Elevated blood pressure and reduced ultrafiltration are linked to LVH development.
- These findings highlight the need for vigilant cardiovascular monitoring in children on PD.
Abstract:
Peritoneal dialysis (PD) is the most common renal replacement therapy used in pediatric patients with end stage renal disease. This population has a mortality rate 1,000 times greater compare to pediatric population, mainly due to cardiovascular causes.
Objective:
To characterize pediatric patients on chronic PD in relation to dialysis and cardiovascular outcome.
Patients And Methods:
Cross sectional study. Patients in stable PD according to DOQI criteria were selected. Epidemiological, dialytic, biochemical and cardiovascular variables were registered. Left Ventricular Mass Index (LVMI) was calculated by height/age (g/m2.7). Left Ventricular Hypertrophy (LVH) was diagnosed with > 38.6 g/m2.7, severe LVH > 51 g/m2.7. Data were analyzed using STATA 11.0. continuous variables using ANOVA test and categorical variables were analyzed using χ2 test or Fishers exact test.
Results:
21 patients, 11 males. Mean age 9.2 ± 3.52 years. The most frequent diagnosis was renal dysplasia (52%). Residual and Peritoneal KtV were 0.8 and 1.9 respectively. Fifty-two percent of patients showed LVH, 91% in severe range. A significant relationship between ultrafiltration/m2 and systolic blood pressure was depicted. Also a significant relationship between left ventricular mass index and hemoglobin (p < 0.05) was founded.
Conclusions:
The majority of the population showed left ventricular hypertrophy -particularly severe LVH-, which confirms an increased CV risk in this population. Blood pressure and loss of ultrafiltration were founded to be correlated to LVH.
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