Key result
LVH and diastolic dysfunction in pediatric CKD are linked to severe six-month cardiovascular risk.
Why the study?
While cardiorenal syndrome is well documented in adults, there is limited understanding of cardiorenal syndrome in paediatric patients with chronic kidney disease.
Observational (n=45)
Structural and functional cardiac changes are highly prevalent among children with CKD, putting them at significant risk of cardiovascular events and death.
LVH and diastolic dysfunction in pediatric CKD were associated with early CV events or death; hypothesis-generating and should not yet change practice.
BACKGROUND: While the presence of cardiorenal syndrome in the adult population is well-documented, there is limited understanding of cardiorenal syndrome in paediatric patients with chronic kidney disease (CKD). Our objective was to assess the prevalence of left ventricular hypertrophy, left ventricular diastolic dysfunction, and left ventricular systolic dysfunction in children with CKD. Additionally, we conducted follow-up evaluations to track the incidence of cardiac events. METHODS: We recruited children aged 2-18 years old with estimated glomerular filtration rate (eGFR) ≤ 45 mL/min/1.73 m2 or on dialysis, and performed transthoracic echocardiography to evaluate the left ventricular mass and left ventricular systolic and diastolic function. They underwent anthropometric assessment and serum measurement at baseline, and were followed up for 6 months. RESULTS: Among 45 children recruited, 33 (73.3%) were on dialysis, 28 (84.8%) of whom were on peritoneal dialysis. The prevalences of left ventricular hypertrophy, left ventricular diastolic dysfunction, left ventricular systolic dysfunction were 42.2%, 15.6%, and 8.9%, respectively. Concomitant left ventricular diastolic dysfunction and left ventricular systolic dysfunction were present in 6.7% of children. The presence of left ventricular diastolic dysfunction was significantly associated with left ventricular hypertrophy (P < .001), left ventricular systolic dysfunction (P < .001), and higher left ventricular mass index Z score (P < .001). Left ventricular hypertrophy was associated with the presence of hypertension (P = .035) and inadequate blood pressure (BP) control (P = .033), while left ventricular diastolic dysfunction was associated with lower body mass index (BMI) z score (P = .01) and lower serum albumin (P = .045). Over a 6-month follow up period, 52.6% of children with left ventricular hypertrophy and 71.4% with left ventricular diastolic dysfunction developed a cardiovascular event or died. CONCLUSION: Structural and functional cardiac changes are highly prevalent among children with CKD, putting them at significant risk of cardiovascular events and death.
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Adnan et al. (2026) conducted an observational in Chronic kidney disease (n=45). Chronic kidney disease was evaluated on Prevalence of left ventricular hypertrophy, left ventricular diastolic dysfunction, and left ventricular systolic dysfunction. Left ventricular hypertrophy (42.2%) and diastolic dysfunction (15.6%) were prevalent in children with CKD; 52.6% and 71.4% of these respective groups had a cardiovascular event or died at 6 months.
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