Top

Published in:

01-01-2005 | Original Article

Abnormal left ventricular mass and aortic distensibility in pediatric dialysis patients

Authors: Renee F. Robinson, Milap C. Nahata, Elizabeth Sparks, Curt Daniels, Donald L. Batisky, John R. Hayes, John D. Mahan

Published in: Pediatric Nephrology | Issue 1/2005

Abstract

There is ample evidence that the same pathophysiological processes that affect cardiovascular function in adults with end-stage renal disease (ESRD) also operate in children with ESRD. In adults undergoing hemodialysis (HD), a good correlation has been established between left ventricular mass (LVM) and aortic distensibility (AD) as markers of cardiovascular disease progression; however, this correlation has not been established in children. Therefore, in this retrospective study we investigated some aspects of cardiovascular damage (i.e., LVM, LVMI, and AD) in children with ESRD undergoing HD ( n =9) or peritoneal dialysis (PD, n =9), and analyzed the relationship between AD, LVM, LVMI, pre-dialysis, post-dialysis blood pressure (BP), and demographic factors in children and adolescents with ESRD. Both LVM and AD were significantly greater in the dialysis population than in a control population derived from our institutional files ( P =0.015, P =0.001). LVM and LVMI in children undergoing HD (92.9±83.7 g, 80.1±31.1 g/cm) were not statistically different from the values in children on PD (130.0±89.2 g, 89.6±35.9 g/cm), ( P =0.3, P =0.5). AD in children on HD (2.2±0.55 cm²* dynes^–1*10–6) was significantly lower than in children on PD (2.7±0.54 cm²* dynes^–1*10–6), ( P =0.01). The findings in this study confirm earlier studies that demonstrated that LVMI is greater in children on dialysis. This study also demonstrates that abnormal vascular stiffness, as defined by AD, is present in these children. The degree of vascular stiffness in children receiving HD is greater than in children receiving PD. However, further study is needed to address how control of BP, uremia, and other factors may affect these abnormalities in children with ESRD.

Groothoff JW, Gruppen MP, Offringa M, Hutten J, Lilien MR, Van De Kar NJ, Wolff ED, Davin JC, Heymans HS (2002) Mortality and causes of death of end-stage renal disease in children: a Dutch cohort study. Kidney Int 61:621–629CrossRefPubMed

Greaves SC, Sharpe DN (1992) Cardiovascular disease in patients with end-stage renal failure. Aust N Z J Med 22:153–159PubMed

(1992) Comorbid conditions and correlations with mortality risk among 3,399 incident hemodialysis patients. Am J Kidney Dis 20:32–38

Wizemann V, Schafer R, Kramer W (1993) Follow-up of cardiac changes induced by anemia compensation in normotensive hemodialysis patients with left-ventricular hypertrophy. Nephron 64:202–206PubMed

London GM, De Vernejoul MC, Fabiani F, Marchais SJ, Guerin AP, Metivier F, London AM, Llach F (1987) Secondary hyperparathyroidism and cardiac hypertrophy in hemodialysis patients. Kidney Int 32:900–907PubMed

de Lima JJ, Abensur H, Krieger EM, Pileggi F (1996) Arterial blood pressure and left ventricular hypertrophy in haemodialysis patients. J Hypertens 14:1019–1024PubMed

Conion PJ, Walshe JJ, Heinle SK, Minda S, Krucoff M, Schwab SJ (1996) Predialysis systolic blood pressure correlates strongly with mean 24-hour systolic blood pressure and left ventricular mass in stable hemodialysis patients. J Am Soc Nephrol 7:2658–2663PubMed

White WB (1992) Impact of the daily blood pressure load on the development of hypertensive heart disease. Cardiology 81:299–306PubMed

Groothoff JW, Gruppen MP, Offringa M, De Groot E, Stok W, Bos WJ, Davin JC, Lilien MR, Van De Kar NC, Wolff ED, Heymans HS (2002) Increased arterial stiffness in young adults with end-stage renal disease since childhood. J Am Soc Nephrol 13:2953–2961PubMed

10.

Cannella G, Paoletti E, Ravera G, Cassottana P, Araghi P, Mulas D, Peloso G, Delfino R, Messa P (2000) Inadequate diagnosis and therapy of arterial hypertension as causes of left ventricular hypertrophy in uremic dialysis patients. Kidney Int 58:260–268CrossRefPubMed

11.

London GM (2002) Left ventricular alterations and end-stage renal disease. Nephrol Dial Transplant 17 [Suppl 1]:29–36

12.

London G (2001) Pathophysiology of cardiovascular damage in the early renal population. Nephrol Dial Transplant 16 [Suppl] 2:3–6

13.

London GM, Pannier B, Guerin AP, Blacher J, Marchais SJ, Darne B, Metivier F, Adda H, Safar ME (2001) Alterations of left ventricular hypertrophy in and survival of patients receiving hemodialysis: follow-up of an interventional study. J Am Soc Nephrol 12:2759–2767PubMed

14.

Parfrey PS, Harnett JD, Griffiths SM, Gault MH, Barre PE (1988) Congestive heart failure in dialysis patients. Arch Intern Med 148:1519–1525CrossRefPubMed

15.

Belsha CW, Wells TG, McNiece KL, Seib PM, Plummer JK, Berry PL (1998) Influence of diurnal blood pressure variations on target organ abnormalities in adolescents with mild essential hypertension. Am J Hypertens 11:410–417CrossRefPubMed

16.

Daniels SR, Loggie JM, Khoury P, Kimball TR (1998) Left ventricular geometry and severe left ventricular hypertrophy in children and adolescents with essential hypertension. Circulation 97:1907–1911PubMed

17.

Daniels SR (1999) Hypertension-induced cardiac damage in children and adolescents. Blood Press Monit 4:165–170PubMed

18.

Daniels SR (2002) Cardiovascular sequelae of childhood hypertension. Am J Hypertens 15:61S–63SCrossRefPubMed

19.

Chamontin B, Amar J, Barthe P, Salvador M (1994) Blood pressure measurements and left ventricular mass in young adults with arterial hypertension screened at high school check-up. J Hum Hypertens 8:357–361PubMed

20.

Sorof JM, Cardwell G, Franco K, Portman RJ (2002) Ambulatory blood pressure and left ventricular mass index in hypertensive children. Hypertension 39:903–908CrossRefPubMed

21.

Sorof JM, Alexandrov AV, Cardwell G, Portman RJ (2003) Carotid artery intimal-medial thickness and left ventricular hypertrophy in children with elevated blood pressure. Pediatrics 111:61–66CrossRefPubMed

22.

Levy D, Garrison RJ, Savage DD, Kannel WB, Castelli WP (1990) Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 322:1561–1566PubMed

23.

Foley RN, Parfrey PS, Harnett JD, Kent GM, Murray DC, Barre PE (1996) Impact of hypertension on cardiomyopathy, morbidity and mortality in end-stage renal disease. Kidney Int 49:1379–1385PubMed

24.

Blacher J, Guerin AP, Pannier B, Marchais SJ, Safar ME, London GM (1999) Impact of aortic stiffness on survival in end-stage renal disease. Circulation 99:2434–2439PubMed

25.

Blacher J, Pannier B, Guerin AP, Marchais SJ, Safar ME, London GM (1998) Carotid arterial stiffness as a predictor of cardiovascular and all-cause mortality in end-stage renal disease. Hypertension 32:570–574PubMed

26.

Guerin AP, Blacher J, Pannier B, Marchais SJ, Safar ME, London GM (2001) Impact of aortic stiffness attenuation on survival of patients in end-stage renal failure. Circulation 103:987–992PubMed

27.

Pasierski TJ, Binkley PF, Pearson AC (1992) Evaluation of aortic distensibility with transesophageal echocardiography. Am Heart J 123:1288–1292CrossRefPubMed

28.

Wright JS, Cruickshank JK, Kontis S, Dore C, Gosling RG (1990) Aortic compliance measured by non-invasive Doppler ultrasound: description of a method and its reproducibility. Clin Sci 78:463–468PubMed

29.

Matsumoto Y, Hamada M, Hiwada K (2000) Aortic distensibility is closely related to the progression of left ventricular hypertrophy in patients receiving hemodialysis. Angiology 51:933–941PubMed

30.

Troy BL, Pombo J, Rackley CE (1972) Measurement of left ventricular wall thickness and mass by echocardiography. Circulation 45:602–611PubMed

31.

Sahn DJ, DeMaria A, Kisslo J, Weyman A (1978) Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 58:1072–1083PubMed

32.

Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, Reichek N (1986) Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 57:450–458CrossRefPubMed

33.

(1996) Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. Pediatrics 98:649–658

34.

Lorell BH, Carabello BA (2000) Left ventricular hypertrophy: pathogenesis, detection, and prognosis. Circulation 102:470–479PubMed

35.

Silberberg JS, Barre PE, Prichard SS, Sniderman AD (1989) Impact of left ventricular hypertrophy on survival in end-stage renal disease. Kidney Int 36:286–290PubMed

36.

Foley RN, Parfrey PS, Harnett JD, Kent GM, Murray DC, Barre PE (1995) The prognostic importance of left ventricular geometry in uremic cardiomyopathy. J Am Soc Nephrol 5:2024–2031PubMed

37.

Matsumoto Y, Honda T, Hamada M, Matsuoka H, Hiwada K (1996) Evaluation of aortic distensibility in patients with coronary artery disease by use of cine magnetic resonance. Angiology 47:149–155PubMed

38.

Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, Ducimetiere P, Benetos A (2001) Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 37:1236–1241PubMed

39.

Ghali JK, Liao Y, Simmons B, Castaner A, Cao G, Cooper RS (1992) The prognostic role of left ventricular hypertrophy in patients with or without coronary artery disease. Ann Intern Med 117:831–836PubMed

40.

Foley RN, Parfrey PS, Harnett JD, Kent GM, Murray DC, Barre PE (1996) Hypoalbuminemia, cardiac morbidity, and mortality in end-stage renal disease. J Am Soc Nephrol 7:728–736PubMed

41.

Enia G, Mallamaci F, Benedetto FA, Panuccio V, Parlongo S, Cutrupi S, Giacone G, Cottini E, Tripepi G, Malatino LS, Zoccali C (2001) Long-term CAPD patients are volume expanded and display more severe left ventricular hypertrophy than haemodialysis patients. Nephrol Dial Transplant 16:1459–1464CrossRefPubMed

42.

Zeier M, Geberth S, Schmidt KG, Mandelbaum A, Ritz E (1993) Elevated blood pressure profile and left ventricular mass in children and young adults with autosomal dominant polycystic kidney disease. J Am Soc Nephrol 3:1451–1457PubMed

43.

Van Bortel LM, Struijker-Boudier HA, Safar ME (2001) Pulse pressure, arterial stiffness, and drug treatment of hypertension. Hypertension 38:914–921PubMed

44.

Nishikimi T, Yoshihara F, Morimoto A, Ishikawa K, Ishimitsu T, Saito Y, Kangawa K, Matsuo H, Omae T, Matsuoka H (1996) Relationship between left ventricular geometry and natriuretic peptide levels in essential hypertension. Hypertension 28:22–30PubMed

45.

Cowie MR, Struthers AD, Wood DA, Coats AJ, Thompson SG, Poole-Wilson PA, Sutton GC (1997) Value of natriuretic peptides in assessment of patients with possible new heart failure in primary care. Lancet 350:1349–1353CrossRefPubMed

46.

Strozecki P, Adamowicz A, Nartowicz E, Odrowaz-Sypniewska G, Wlodarczyk Z, Manitius J (2001) Parathormon, calcium, phosphorus, and left ventricular structure and function in normotensive hemodialysis patients. Ren Fail 23:115–126CrossRefPubMed

47.

Moon KH, Song IS, Yang WS, Shin YT, Kim SB, Song JK, Park JS (2000) Hypoalbuminemia as a risk factor for progressive left-ventricular hypertrophy in hemodialysis patients. Am J Nephrol 20:396–401CrossRefPubMed

Title: Abnormal left ventricular mass and aortic distensibility in pediatric dialysis patients
Authors: Renee F. Robinson
Milap C. Nahata
Elizabeth Sparks
Curt Daniels
Donald L. Batisky
John R. Hayes
John D. Mahan
Publication date: 01-01-2005
Publisher: Springer-Verlag
Published in: Pediatric Nephrology / Issue 1/2005
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-004-1667-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abnormal left ventricular mass and aortic distensibility in pediatric dialysis patients

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 1/2005

Risks of kidney pool implantation

Bone disease in nephrotic syndrome—prevention is better than cure

Cyclosporin A does not affect platelets in children with idiopathic nephrotic syndrome

Levamisole in steroid-sensitive nephrotic syndrome of childhood: the lost paradise?

Sleep disturbances in pediatric dialysis patients

Proximal renal tubular dysfunction in primary distal renal tubular acidosis