Early cardiac dysfunction in pediatric patients on maintenance dialysis and post kidney transplant.

Pediatric Nephrology : Journal of the International Pediatric Nephrology Association
Rossana Malatesta-MuncherMark Mitsnefes

Abstract

Children with advanced chronic kidney disease (CKD) frequently develop left ventricular (LV) hypertrophy. The extent of hypertrophy that results in cardiac dysfunction is unknown. Systolic function, routinely determined by ejection fraction (EF), is usually preserved in these patients. However, a decrease in EF represents an advanced cardiac dysfunction. We used cardiac magnetic resonance (CMR) and phosphorus-31 MR spectroscopy (31P MRS) to assess markers of cardiac dysfunction in young CKD patients. Ten dialysis and ten post-transplant patients completed the study. The outcomes were peak LV myocardial circumferential strain (Ecc); myocardial T2 relaxation time and full width at half maximum (FWHM) of T2 distribution; and phosphocreatinine/adenosine triphosphate (PCr/ATP) to measure muscle energy metabolism. Healthy controls were used for comparison. All patients had normal EF; nine (45%) had low Ecc. Ecc was lower in dialysis versus transplant (p<0.0001) patients and inversely correlated with LV mass index, r= -0.47, p=0.04. Patients had higher T2 (p=0.056) and FWHM (p=0.01) than controls. T2 levels were positively correlated with LVM index (r=0.46, p=0.04). PCr/ATP was lower in patients than in controls (p=0.02). Young patien...Continue Reading

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Citations

Jun 13, 2012·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Dorota Polak-Jonkisz, Malgorzata Sobieszczanska
Dec 18, 2013·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Francesca MencarelliGiovanni Montini
Sep 8, 2015·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Raoul ArnoldCharlotte Gimpel
Mar 19, 2016·The Journal of Clinical Hypertension·Katarina Supe-MarkovinaRobert P Woroniecki
Jan 1, 2014·Frontiers in Cardiovascular Medicine·Susie F C ParnhamJoseph B Selvanayagam
Sep 28, 2013·Journal of the American Society of Nephrology : JASN·Juan C KupfermanUNKNOWN CKiD Study Group
Mar 27, 2019·F1000Research·Dulitha K HewadikaramJanaka P Wansapura
Mar 10, 2017·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Rawan K RummanMichael Grattan
May 30, 2017·Frontiers in Pediatrics·Robert P WoronieckiKatarina Supe-Markovina

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