An Echocardiographic Assessment of Cardiac Functions and Structure in Children on Dialysis

Haciomeroglu, Pelin; Özkaya, Ozan; Günal, Nazlıhan; Baysal, Kemal

doi:10.1080/08860220701805216

Cited by 5 publications

(4 citation statements)

References 26 publications

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“…There was no significant difference between the groups considering EF and SF levels, which are indicators of left ventricular systolic functions [43,44]. In our study we found that diastolic functions are affected much earlier than suggested by several previous studies [43,45]. We found a positive correlation between levels of NT-proBNP and OH, Rel OH, ECW/ICW, LAD, and LVMI and an inverse correlation with E/A ratio.…”

Section: Discussionsupporting

confidence: 50%

Is N-terminal pro-brain natriuretic peptide a reliable marker for body fluid status in children with chronic kidney disease?

Nalçacıoğlu

Özkaya

Kafalı

et al. 2020

aoms

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Introduction: Brain natriuretic peptides, released in response to left ventricular stress, have a strong prognostic value in dialysis patients. However, their role in detecting abnormalities of fluid status is under debate; the relationship between volume status and brain natriuretic peptides (BNPs) differs among various studies. The aim of our study was to evaluate the clinical utility of N-terminal proBNP in the assessment of fluid status and cardiovascular risk in this setting. Material and methods: The study included 65 children: 10 pre-dialysis, 13 hemodialysis, 12 peritoneal dialysis patients and 30 healthy controls. Volume status was determined by multifrequency bioimpedance and NTpro-BNP, as well as echocardiography to estimate the left ventricle structure and function. Results: The median log NT-proBNP values of hemodialysis and peritoneal dialysis patients were 3.66 (2.05-4.90) and 3.57 (2.51-4.13) pg/ml, respectively, and significantly higher compared with the control group (p < 0.001, p < 0.001). On simple correlation, NT-proBNP was correlated with markers of volume overload and cardiac dysfunction. On multivariate regression analysis, only left ventricle mass index (β = 0.402, p = 0.003) and left atrium diameter (β = 0.263, p = 0.018) were independently associated with NT-proBNP (adjusted R 2 of the model: 0.707, p < 0.001). Conclusions: Our research suggested that NT-proBNP, which was correlated with LV systolic and diastolic dysfunction and fluid overload as assessed by bioimpedance, can be used to evaluate cardiovascular states in a chronic kidney disease (CKD) population. From the early stages of CKD, periodic monitoring of NT-proBNP levels may be essential for early detection of patients with high risk of cardiovascular events, and for taking preventive intervention as soon as possible.

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Section: Discussionsupporting

confidence: 50%

Is N-terminal pro-brain natriuretic peptide a reliable marker for body fluid status in children with chronic kidney disease?

Nalçacıoğlu

Özkaya

Kafalı

et al. 2020

aoms

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“…Cardiovascular disease is a leading cause of long‐term morbidity and mortality among children with chronic kidney disease, and left ventricular hypertrophy (LVH) is an independent risk factor for cardiovascular complications in patients with end‐stage renal disease (ESRD) . A number of studies have found a high prevalence of LVH in children with ESRD, ranging from 40% to 85% . Hypertension, a high body mass index, renal diseases other than hypodysplasia, anemia, and hyperparathyroidism have all been identified as independent predictors of LVH, and hemodialysis (HD), as opposed to peritoneal dialysis, has been reported to be a significant risk factor in children with ESRD .…”

Section: Introductionmentioning

confidence: 99%

Bioimpedance analysis and cardiovascular status in pediatric patients on chronic hemodialysis

Paglialonga

Ardissino

Galli

et al. 2012

Hemodialysis International

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Bioimpedance analysis (BIA) is reported to be useful in assessing dry weight (DW) in patients on hemodialysis (HD), but its exact role has never been clearly defined. We reviewed our experience of using the BIA measure of reactance (Xc) in pediatric patients on chronic HD. Our approach is currently based on identifying a range of patient-specific Xc values at which a child can be considered at DW according to a multidisciplinary assessment. Values lower than the patient-specific limit suggests the need for a reduction in DW, whereas values higher than the limit suggest that DW should be increased. The accuracy of our approach was retrospectively assessed by analyzing the left ventricular mass index (LVMI) and the incidence of pulmonary edema (PE) in two groups: The first consisted of 13 patients (median age 15.6 years) on dialysis in 2007, before the introduction of the BIA-based approach; the second included 18 patients (median 14.8 years) on dialysis in 2011. In 2007, three children experienced four episodes of PE, whereas no PE occurred in 2011. The median LVMI was 56.8 g/m(2.7) in 2007, and 44.5 g/m(2.7) in 2011 (P < 0.05). The percentage of patients with LV hypertrophy (LVMI>38.5 g/m(2.7)) was 92.3% in 2007 and 61.1% in 2011 (P < 0.05). There were no between-group differences in terms of blood pressure, antihypertensive medications, percentage of symptomatic sessions, or biochemistry. In conclusion, a simple approach based on BIA may be useful in assessing DW in pediatric patients on HD, and thus improve their cardiovascular status.

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“…Diastolic dysfunction, which is identified by both pulse-wave Doppler and tissue Doppler, has been observed in patients receiving dialysis therapy for ESRD in many studies (25,26). When patients with CKD were compared to healthy subjects, a lower mitral E/A ratio, Em/Am ratio and Em velocity were found (27)(28)(29). However investigators reported that LV and RV functions did not change in patients with CKD after long-term HD treatment in a few studies (9).…”

Section: Discussionmentioning

confidence: 99%

Effect of Peritoneal Dialysis Treatment on Left Ventricular Systolic and Diastolic Functions in Patients with End-Stage Renal Disease

Kavuncuoğlu¹,

Ünal²,

Koçyiğit³

et al. 2014

Turk Neph Dial Transpl

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OBJectIve: To analyze the effect of peritoneal dialysis (PD) treatment on left ventricular systolic and diastolic function in patients with end-stage renal disease (ESRD). MAterIAl and MethODS: The study population consisted of 51 patients with ESRD. Before a PD catheter was inserted, the patients were evaluated by echocardiography and Doppler tissue imaging (DTI). Then, a PD catheter was inserted. After 6 months, the second echocardiographic evaluations were performed. Left ventricular systolic and diastolic function parameters were compared. reSultS: The mean age was 47 ± 13 years and 38 (74.5%) of the patients were male. No significant difference was found in echocardiographic parameters including ejection fraction, fractional shortening, left ventricular mass, left ventricular mass index, left ventricular posterior wall thickness, inter ventricular septal thickness, left atrial diameter, early diastolic filling/late diastolic filling ratio before and after the period of PD. Left ventricular end-systolic diameter and left ventricular end-diastolic diameter values were significantly lower found in the period after PD. cOncluSIOn: Our findings appear to reflect somewhat the favourable changes in LV diastolic and systolic functions in PD patients.

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An Echocardiographic Assessment of Cardiac Functions and Structure in Children on Dialysis

Cited by 5 publications

References 26 publications

Is N-terminal pro-brain natriuretic peptide a reliable marker for body fluid status in children with chronic kidney disease?

Is N-terminal pro-brain natriuretic peptide a reliable marker for body fluid status in children with chronic kidney disease?

Bioimpedance analysis and cardiovascular status in pediatric patients on chronic hemodialysis

Effect of Peritoneal Dialysis Treatment on Left Ventricular Systolic and Diastolic Functions in Patients with End-Stage Renal Disease

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An Echocardiographic Assessment of Cardiac Functions and Structure in Children on Dialysis

Cited by 5 publications

References 26 publications

Is N-terminal pro-brain natriuretic peptide a reliable marker for body fluid status in children with chronic kidney disease?

Is N-terminal pro-brain natriuretic peptide a reliable marker for body fluid status in children with chronic kidney disease?

Bioimpedance analysis and cardiovascular status in pediatric patients on chronic hemodialysis

Effect of Peritoneal Dialysis Treatment on Left Ventricular Systolic and ￼Diastolic Functions in Patients with End-Stage Renal Disease

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Effect of Peritoneal Dialysis Treatment on Left Ventricular Systolic and Diastolic Functions in Patients with End-Stage Renal Disease