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Pediatric Nephrology

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01-09-2016 | Original Article

Assessing longitudinal trends in cardiac function among pediatric patients with chronic kidney disease

Authors: Ylva Tranæus Lindblad, Georgios Vavilis, Jonas Axelsson, Maria Herthelius, Peter Bárány

Published in: Pediatric Nephrology | Issue 9/2016

Abstract

Background

Left ventricular diastolic dysfunction (LVDD) is an early marker of cardiac disease in pediatric chronic kidney disease (CKD), but few studies have analyzed longitudinal trends. We conducted a prospective 3-year follow-up study in pediatric CKD and kidney transplant (CKD-T) patients.

Methods

The patient cohort comprised 30 CKD and 42 CKD-T patients. The results of annual clinical and echocardiographic analyses using tissue Doppler imaging (TDI) and pulse wave Doppler (PWD) were assessed, and associations to predictive risk factors were studied using multivariate modeling.

Results

The mean age of CKD and CKD-T patients at inclusion was 9.8 ± 4.4 and 11.8 ± 4.3 years, respectively; the glomerular filtration rate was 35.3 ± 18.3 and 60.3 ± 18.8 mL/min/1.73 m², respectively. The prevalence of left ventricular diastolic dysfunction (LVDD), as assessed using TDI (lateral z-score e′) was 7.1 and 12.5 % in CKD and CKD-T patients, respectively; the corresponding values with PWD E were 3.3 and 2.4 %, respectively. In unadjusted analyses, both TDI and PWD markers of diastolic function worsened over the follow-up period; following adjustments, an elevated systolic ambulatory blood pressure was the most important predictor of cardiac disease.

Conclusions

Children with CKD show early signs of LVDD, with TDI being more sensitive than PWD in terms of diagnostic potential. An increased ambulatory systolic blood pressure predicted progression in diastolic function, suggesting opportunities for future interventions.

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Title: Assessing longitudinal trends in cardiac function among pediatric patients with chronic kidney disease
Authors: Ylva Tranæus Lindblad
Georgios Vavilis
Jonas Axelsson
Maria Herthelius
Peter Bárány
Publication date: 01-09-2016
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 9/2016
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-016-3371-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Assessing longitudinal trends in cardiac function among pediatric patients with chronic kidney disease

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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