Can a Cardiovascular Scoring System be Used to Determine Cardiovascular Disease in Pediatric Dialysis Patients?

We created a two scoring systems for pediatric dialysis patients to determine the presence of cardiovascular disease (CVD) which are referred to as (CVDS)-1 and CVDS-2. We included 25 patients on hemodialysis (n = 19) and peritoneal dialysis (n = 6). CVDS-1 and CVDS-2 use multiple parameters, to determine the presence of CVD in pediatric dialysis patients. The scoring systems include renal pathology, nutrition, dialysis adequacy, residual urine output, protein catabolism, dialysis modality and some laboratory values. CVD evaluations included the left ventricular mass index, pulse wave velocity and carotid intima-media thickness measurements. The mean age was 11.1 ± 6.51 years, and the male-female ratio was 14:11. Patients on peritoneal dialysis had higher serum levels of calcium × phosphorus product and diastolic blood pressure (P = 0.013 and P = 0.006, respectively). We did not find any significant correlation between peritoneal dialysis and hemodialysis patients in the CVDS-1 and CVDS-2 scores (P >0.005). The CVDS-1 system had a sensitivity of 90% and a specificity 80%. The CVDS-2 system had a sensitivity of 90% and a specificity 66%. Additionally, the area under the receiver operating characteristic curve of CVDS-1 was 0.913 (95% confidence interval (CI) = 0.80-1.00, P <0.001) for a diagnosis of CVD and that of CVDS-2 was 0.86 (95% CI = 0.72-1.00, P <0.001). We believe that CVDS-1 will be more successful in determining the presence of CVD with the biochemical parameters we use in clinical practice on a monthly basis.