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Cardiac Abnormalities in Children with Pre-Dialysis Chronic Kidney Disease in a Resource-Limited Setting: A

Naveen Bhagat1, Lesa Dawman1, Sanjeev Naganur2

  • 1Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.

Journal of Tropical Pediatrics
|September 7, 2021
PubMed

Insights

Cardiac abnormalities are common in children with chronic kidney disease (CKD), with diastolic dysfunction and enlarged left ventricles being most prevalent. These findings correlate with CKD severity and specific lab values.

Area of Science:

  • Pediatric Nephrology
  • Cardiology
  • Clinical Medicine

Background:

  • Cardiovascular disease is a major cause of death in pediatric chronic kidney disease (CKD).
  • Understanding cardiac abnormalities in this population is crucial for improving outcomes.

Purpose of the Study:

  • To determine the prevalence of cardiac abnormalities in children with CKD.
  • To investigate associations between cardiac issues and risk factors like CKD stage, anemia, and lab parameters.

Main Methods:

  • Cross-sectional observational study of 107 children with CKD.
  • 2D echocardiography and M-mode measurements assessed left ventricular (LV) systolic and diastolic function.
  • LV parameters were indexed for body surface area (BSA) and compared with age, sex, CKD stage, anemia, estimated glomerular filtration rate (eGFR), and laboratory results.

Main Results:

  • LV diastolic dysfunction (88%) and increased LV dimensions (33.6%) were most common.
  • LV dimensions correlated with parathormone, eGFR, serum calcium, and hemoglobin.
  • Left ventricular hypertrophy showed similar correlations, while ejection fraction related inversely to parathormone and directly to eGFR and calcium.

Conclusions:

  • LV diastolic dysfunction and increased LV dimensions are the most frequent cardiac abnormalities in pediatric CKD.
  • These abnormalities are linked to CKD severity, parathormone levels, eGFR, serum calcium, and hemoglobin.
  • Diastolic dysfunction is associated with higher serum creatinine and parathormone levels.
Abstract

Keywords:
cardiac abnormalitieschildrenchronic kidney diseaseechocardiographyleft ventricular hypertrophy

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