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Aortic Root Dilatation in Children With End-Stage Kidney Disease on Regular Hemodialysis and After Kidney

Fatina I Fadel1, Doaa M Salah1, Hend A Elnaggar1

  • 1Faculty of Medicine, Cairo University Children Hospital, Kasr Al Ainy, Cairo University, Cairo, Egypt.

Pediatric Transplantation
|February 3, 2025
PubMed

Insights

Aortic root dilatation (ARD) is common in children with end-stage kidney disease (ESKD), especially those on hemodialysis. Risk factors include younger age, low BMI, hypertension, and high calcium-phosphate levels.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Health in Chronic Kidney Disease
  • Medical Imaging in Pediatrics

Background:

  • Cardiovascular disease (CVD) is a leading cause of mortality in end-stage kidney disease (ESKD) patients.
  • Aortic root dilatation (ARD) is an emerging cardiovascular complication in pediatric ESKD.
  • This study investigates ARD in children undergoing hemodialysis (HD) and kidney transplantation (KT).

Purpose of the Study:

  • To determine the prevalence of ARD in pediatric ESKD patients on HD versus post-KT.
  • To identify risk factors associated with ARD in this population.
  • To assess the progression and changes in ARD over time.

Main Methods:

  • Echocardiographic assessments were performed on 70 children on HD and 80 pediatric kidney transplant recipients (KTR).
  • Follow-up assessments were conducted over 6–14 months.
  • Data analysis compared ARD prevalence, risk factors, and clinical parameters between groups.

Main Results:

  • ARD prevalence was significantly higher in the HD group (71.4%) compared to the KT group (40%).
  • Risk factors for ARD included longer ESKD duration, higher weight, and elevated blood pressure.
  • Patients with ARD exhibited lower hemoglobin, higher platelets, and altered calcium-×-phosphate levels.

Conclusions:

  • ARD is highly prevalent in pediatric ESKD, more so in HD patients than KTR.
  • Younger age, lower BMI Z-scores, hypertension, and elevated calcium-×-phosphate are key risk factors for ARD.
  • Aortic root dimensions and ARD frequency showed improvement over a 6-month follow-up period.
Abstract

Keywords:
cardiovascular diseasefollow uphypertensionrisk factors

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