Left ventricular mass index as a prognostic factor in children with chronic kidney disease

Abstract

Objective The objective of this study was to evaluate the effect of decreasing renal function on left ventricular mass index (LVMI) in children with chronic kidney disease (CKD) on regular hemodialysis attending Assiut University Hospital for Children, and also to evaluate left ventricular mass changes as predictor of morbidity and mortality of uremic children by using echocardiography, aiming to use it in the future. Patients and methods Baseline clinical characteristics were collected by careful history and examination. Routine laboratory methods were used to measure biochemical parameters: hemoglobin, C-reactive protein, phosphorus, calcium, parathyroid hormone, and lipid profile after patients fasted for 8 h. Echocardiographic parameters were measured within 2–24 h after a dialysis session. Results In this study, we studied 36 children on regular hemodialysis. The age of our patients ranged from 3.5 to 16 years, and the number of male patients was similar to female patients. In our study. we found eccentric left ventricular hypertrophy was predominant (38.9%) compared with concentric left ventricular hypertrophy (13.9%). We found that 52.8% of patients had increased LVMI and 47.2% had normal LVMI. Regarding the fate of our cases, 39% died during the study period, whereas the other 61% survived. Mortality among patients with increased LVMI was higher (28%) than among patients with normal LVMI (11%). Conclusion Children with CKD are prone to development of cardiac dysfunctions, so early and regular echocardiographic studies of all children with CKD to detect early cardiac changes and institute interventions and follow-up are required.