Assessment of Left Ventricular Geometry in Children with Chronic Kidney Disease Undergoing Peritoneal Dialysis

Öz

Objective: Cardiovascular morbidity seems increased in children with chronic renal failure, but the age and stage of disease when cardiac alterations become manifest are unknown. The aim of our study was aimed to evaluate the left ventricular geometry of children with chronic renal failure (CRF) undergoing peritoneal dialysis.

Material and Methods: Echocardiographic and biochemical data were evaluated in 20 children on peritoneal dialysis (PD). Left ventricular mass index and relative wall thickness was calculated. There were 20 healthy control.

Results: Left ventricular mass index and relative wall thickness were found significantly higher in CRF group compared to control group (respectively 88.03±37.09; 41.16±12.52 and 0.62±0.12; 0.39±0.08, p>0.05). There was significant correlation between left ventricular mass index and systolic blood pressures and parathormone (respectively r=0.428, p=0.03; r=-0.501, p=0.02). An abnormal left ventricular geometric pattern was present in 17/20 (85%) children with CRF. Concentric hypertrophy was the most common geometric pattern in the study. Nine (45%) of patients with CRF had left ventricular concentric hypertrophy. Left ventricular systolic functions were found normal in patients with CRF(EF 65.63±6.71% and FS 35.7±10.25%).

Conclusion: Left ventricular hypertrophy (LVH) can be progresses in children with chronic renal failure. The strict control of blood pressure and hyperparathyroidism might be important in preventing the development of LVH in these patients.

Anahtar Kelimeler

• Echocardiography
• Peritoneal dialysis
• Left ventricular geometry

Periton Diyalizi Programında İzlenen Kronik Böbrek Yetersizlikli Çocuklarda Sol Ventrikül Geometrisinin Değerlendirilmesi

Öz

Amaç: Kronik böbrek yetmezliği (KBY) olan çocuklarda kardiyovasküler morbidite artmıştır. Ancak kardiyak değişikliklerin hastalığın hangi evresinde ortaya tam olarak bilinmemektedir. Bu çalışmada periton diyaliz programında izlenen son dönem böbrek yetmezliği olan çocuklarda sol ventrikül geometrisinin değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntemler: Periton diyalizinde izlenen 20 KBY’li çocukta ekokardiyografik ve biyokimyasal veriler değerlendirildi. Sol ventrikül kitlesi ve rölatif duvar kalınlığı hesaplandı. Kontrol grup olarak 20 sağlıklı çocuk alındı.

Bulgular: Sol ventrikül kitle indeksi ve rölatif duvar kalınlığı KBY grubunda kontrol grubuna göre anlamlı olarak yüksek bulundu (sırasıyla 88.03 ± 37.09; 41.16 ± 12.52 ve 0.62 ± 0.12; 0.39 ± 0.08, p>0.05). Sol ventrikül kitle indeksi ile sistolik kan basıncı ve parathormon arasında anlamlı bir ilişki vardı (sırasıyla r=0.428, p=0.03; r=-0.501, p=0.02). KBY’li 17’sinde (%85) çocukta anormal sol ventrikül geometrisi mevcuttu. Konsantrik hipertrofi, çalışmada en sık anomal sol ventrikül geometrisiydi. Periton diyalizi olan hastaların 9’unda (%45) sol ventrikülde konsantrik hipertrofi izlendi. KBY’li çocuklarda sol ventrikül sistolik fonksiyonları normal sınırlar içindeydi (EF %65.63±6.71 ve FS %35.7±10.25).

Sonuç: Sol ventrikül hipertrofisi (LVH) kronik böbrek yetmezliği olan çocuklarda ilerleyicidir. Kan basıncının ve hiperparatiroidizimin daha yakın kontrolü bu hastalarda LVH gelişimini önlemede önemli olabilir.

Anahtar Kelimeler

• ekokardiyografi
• periton diyalizi
• sol ventrikül geometrisi

Kaynakça

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