Background Cardiovascular disease is the leading cause of morbidity and mortality in children with chronic kidney disease (CKD). We aim to estimate the prevalence of cardiac abnormalities in children up to age 16 years with CKD and their association with various risk factors. Methods This cross-sectional observational study was conducted on 107 CKD children. We assessed the systolic and diastolic function using 2D echocardiographic evaluation and M-mode measurements of the left ventricle (LV) indexed for BSA and z-scores were calculated. Results were compared with age, sex, stage of CKD, anaemia, estimated glomerular filtration rate (eGFR) and various laboratory parameters. Results LV diastolic dysfunction was seen in 88%, followed by increased LV dimensions in 33.6%, LV systolic dysfunction in 16%, right ventricle systolic dysfunction in 11.2% while increased pulmonary artery (PA) systolic pressure was seen in 9.3% of cases. LV dimensions correlated directly with parathormone levels and inversely with eGFR, serum calcium and haemoglobin levels. Left ventricular hypertrophy correlated directly with parathormone while inversely with eGFR, serum calcium and haemoglobin. Ejection fraction directly correlated to eGFR and serum calcium while inversely related to parathormone. Left PA pressure directly correlated with age and inversely with eGFR. Right ventricular systolic function assessed by tricuspid annular plane systolic excursion correlated inversely with haemoglobin. Conclusion LV diastolic dysfunction and increased LV dimensions were the most common cardiac abnormality in children with CKD. LV dimensions correlated directly with parathormone levels and inversely with eGFR, serum calcium and haemoglobin. Diastolic dysfunction positively correlated with serum creatinine and parathormone levels.

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在资源有限的情况下透析前慢性肾病儿童的心脏异常：一项横断面观察研究

背景 心血管疾病是慢性肾脏病 (CKD) 儿童发病率和死亡率的主要原因。我们旨在评估 16 岁以下 CKD 儿童心脏异常的患病率及其与各种危险因素的关系。方法 这项横断面观察性研究对 107 名 CKD 儿童进行。我们使用 2D 超声心动图评估和左心室 (LV) 的 M 模式测量值评估了收缩和舒张功能，并计算了 BSA 和 z 分数的索引。将结果与年龄、性别、CKD 分期、贫血、估计的肾小球滤过率 (eGFR) 和各种实验室参数进行比较。结果 LV 舒张功能障碍占 88%，其次是 LV 尺寸增加 33.6%，LV 收缩功能障碍占 16%，右心室收缩功能障碍占 11%。2%，而 9.3% 的病例出现肺动脉 (PA) 收缩压升高。LV 尺寸与甲状旁腺素水平直接相关，与 eGFR、血清钙和血红蛋白水平成反比。左心室肥大与甲状旁腺素直接相关，而与 eGFR、血清钙和血红蛋白呈负相关。射血分数与 eGFR 和血清钙直接相关，而与甲状旁腺素呈负相关。左 PA 压力与年龄直接相关，与 eGFR 成反比。通过三尖瓣环平面收缩偏移评估的右心室收缩功能与血红蛋白呈负相关。结论 左室舒张功能障碍和左室尺寸增加是 CKD 儿童最常见的心脏异常。LV 尺寸与甲状旁腺素水平直接相关，与 eGFR 成反比，血清钙和血红蛋白。舒张功能障碍与血清肌酐和甲状旁腺素水平呈正相关。