Details

Autor(en) / Beteiligte

• Choi, Ann Wing-man
• Fong, Nai-chung
• Li, Vivian Wing-yi
• Ho, Tsz-wai
• Chan, Eugene Yu-hin
• Ma, Alison Lap-tak
• Cheung, Yiu-fai

Titel

Left ventricular stiffness in paediatric patients with end-stage kidney disease

Ist Teil von

• Pediatric nephrology (Berlin, West), 2020-06, Vol.35 (6), p.1051-1060

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2020

Quelle

MEDLINE

Beschreibungen/Notizen

• Background We tested the hypothesis that myocardial stiffness is altered in paediatric patients with end-stage kidney disease (ESKD) and explored its association with clinical parameters of chronic kidney disease (CKD). Methods Thirty-five patients with ESKD (16 males) aged 17.5 ± 3 years old, 18/35 of whom were receiving dialysis and 17 post kidney transplant, were studied. Left ventricular (LV) myocardial stiffness was determined by measurement of diastolic wall strain (DWS) and stiffness index (SI), while LV diastolic function was interrogated by pulsed-wave and tissue Doppler echocardiography. Results Compared with available literature data, both dialysis and transplanted patients had significantly lower DWS and greater SI, reduced transmitral early (E) to late diastolic velocity ratio and septal and lateral mitral annular early (e′) diastolic velocities, and greater septal and lateral E/e′ ratios (all p  < 0.05). Multivariate analysis revealed that z score of diastolic blood pressure ( β  = 0.43, p  = 0.004) and the duration of renal replacement therapy ( β  = 0.55, p  < 0.001) were significant determinants of LV SI. Subgroup analysis in post-transplant patients showed z score of diastolic blood pressure ( β  = 0.54, p  = 0.025) remained as a significant determinant of LV SI. Conclusion Increased LV myocardial stiffness is evident in paediatric dialysis and transplanted patients with ESKD, and is associated with blood pressure and duration of renal replacement therapy.