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[Left Ventricular Mass Index and Cardiovascular Compromise in children on dialysis]

Carolina Sugg H1, Francisco Cano Sch2

  • 1Programa Formación Nefrología Pediátrica, Chile.

Revista Chilena De Pediatria
|April 16, 2021
PubMed

Insights

In children with chronic kidney disease (CKD), chronological age overestimates left ventricular hypertrophy (LVH). Age-adjusted, length/height-corrected LVMI provides a more accurate diagnosis of LVH in stunted CKD patients.

Area of Science:

  • Pediatric Nephrology
  • Cardiology
  • Clinical Diagnostics

Background:

  • Chronic kidney disease (CKD) is closely linked to cardiovascular disease (CVD).
  • Left ventricular hypertrophy (LVH) is a key manifestation of CVD in CKD.
  • Accurate LVH assessment in growth-retarded CKD children requires age-adjusted, length/height-corrected Left Ventricular Mass Index (LVMI).

Purpose of the Study:

  • To compare Left Ventricular Mass Index (LVMI) calculated using chronological age versus age-corrected length/height in pediatric CKD patients on dialysis.
  • To evaluate the diagnostic accuracy of different LVMI calculation methods in this population.

Main Methods:

  • Cross-sectional study analyzing echocardiograms from 26 CKD children (dialysis) aged 1-18 years.
  • LVMI was calculated using chronological age and then adjusted for age-corrected length/height.
  • Descriptive statistics and concordance analysis (Kappa coefficient) were employed.

Main Results:

  • 56% of patients showed LVH by chronological age, compared to 46.6% using age-corrected length/height.
  • 18.6% of patients shifted to a lower percentile group when using the age-adjusted, length/height-corrected LVMI.
  • A Kappa coefficient of 0.72 indicated significant differences between the two calculation methods.

Conclusions:

  • Standard LVMI calculation using chronological age overestimates cardiovascular involvement in stunted CKD children.
  • Age-adjusted, length/height-corrected LVMI offers a more precise diagnosis of LVH in pediatric CKD patients.
  • This refined method improves cardiovascular risk assessment in this vulnerable group.
Abstract

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