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Elevated Mean Pulmonary Artery Pressure and Right Ventricular Dysfunction in Children with Chronic Kidney Disease

Igoche D Peter1, Mustafa O Asani1, Ibrahim Aliyu1

  • 1Paediatric Cardiology Unit, Aminu Kano Teaching Hospital, Bayero University Kano, Nigeria.

Journal of Cardiovascular Echography
|June 19, 2018
PubMed

Insights

Elevated mean pulmonary artery pressure (mPAP) is common in children with chronic kidney disease (CKD), often linked to right heart issues. Children with CKD who have never undergone dialysis show higher mPAP rates.

Area of Science:

  • Pediatric Nephrology
  • Cardiology
  • Pulmonary Hypertension

Background:

  • Elevated mean pulmonary artery pressure (mPAP) and right heart failure are significant mortality factors in chronic kidney disease (CKD) patients.
  • Pulmonary hypertension in pediatric CKD is a growing concern, impacting cardiac health and overall prognosis.
  • Understanding the prevalence and associated factors of elevated mPAP in children with CKD is crucial for early intervention.

Purpose of the Study:

  • To determine the prevalence of elevated mPAP in children with CKD compared to healthy controls.
  • To investigate the association between elevated mPAP and right ventricular dysfunction in pediatric CKD.
  • To explore the relationship between elevated mPAP and a history of hemodialysis in children with CKD.

Main Methods:

  • A cross-sectional comparative study was conducted.
  • 21 children with CKD and age/sex-matched controls without cardiac disease were assessed.
  • Measurements included mean pulmonary artery pressure (mPAP) and tricuspid annular plane systolic excursion.

Main Results:

  • Children with CKD exhibited significantly higher mPAP (27.69 mmHg) than controls (14.55 mmHg, P=0.002).
  • Elevated mPAP was found in 42.9% of the CKD group versus 0% of controls (P<0.001).
  • Right ventricular dysfunction was more prevalent in CKD patients with elevated mPAP (P<0.001), and less common in those who had undergone dialysis (P<0.001).

Conclusions:

  • Elevated mPAP is significantly more prevalent in children with CKD compared to controls.
  • Children with CKD and elevated mPAP are more likely to have impaired right ventricular function.
  • The occurrence of elevated mPAP was more frequent in children with CKD who had never been dialyzed.
Abstract

Keywords:
Chronic kidney diseasemean pulmonary artery pressureright ventricular dysfunctiontricuspid annular plane systolic excursion

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