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Evaluation of subclinical cardiovascular risk and cardiac function in children with vesicoureteral reflux: a

Ahmet Midhat Elmacı1,2, Hayrullah Alp3, Muhammet İrfan Dönmez4

  • 1Department of Pediatric Nephrology, Dr. Ali Kemal Belviranlı Women's Maternity and Children's Hospital, Konya, Turkey.

Cardiology in the Young
|September 29, 2021
PubMed

Insights

Children with vesicoureteral reflux (VUR) show early cardiac dysfunction and subclinical atherosclerosis, regardless of kidney scarring. VUR diagnosis is a significant cardiovascular risk factor needing consideration in patient follow-up.

Area of Science:

  • Pediatric Cardiology
  • Nephrology
  • Vascular Biology

Background:

  • Vesicoureteral reflux (VUR) is a common congenital anomaly of the urinary tract.
  • Renal scarring, linked to chronic inflammation, is a known complication of VUR.
  • Limited research exists on the cardiovascular impact of VUR.

Purpose of the Study:

  • To investigate subclinical atherosclerosis and cardiovascular complications in children diagnosed with VUR.
  • To compare cardiovascular parameters between children with VUR and healthy controls.
  • To assess the influence of renal scarring on cardiovascular outcomes in VUR patients.

Main Methods:

  • A case-control study involving children with VUR and age-matched healthy controls.
  • Patients with VUR were stratified based on the presence or absence of renal scarring.
  • Cardiac function and subclinical atherosclerosis were evaluated using carotid artery intima-media thickness, epicardial adipose tissue, and periaortic adipose tissue measurements via echocardiography.

Main Results:

  • The VUR group exhibited significantly increased myocardial performance indexes (Tei indexes) compared to controls (p < 0.001).
  • Children with VUR showed significantly greater intima-media, epicardial adipose tissue, and periaortic adipose tissue thicknesses than controls (p < 0.001).
  • No significant differences in cardiovascular parameters were found between VUR patients with and without renal scarring.

Conclusions:

  • Vesicoureteral reflux in children leads to early deterioration of cardiac systolic and diastolic functions, irrespective of renal scarring.
  • VUR is an independent risk factor for subclinical atherosclerosis, highlighting the need for cardiovascular monitoring in affected children.
Abstract

Keywords:
Doppler echocardiographyVesicoureteral refluxcardiac functionschildrenrenal scarsubclinical atherosclerosis

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