Assessing Left Ventricular Dysfunction in Pediatric Chronic Kidney Disease Patients: A 2D Echocardiography Study From Ethiopia

Background: Although chronic kidney disease (CKD) is less prevalent among the pediatric population in comparison to adults, it remains a significant contributor to morbidity and mortality in this age group. As the disease advances, it gives rise to diverse complications, with cardiovascular issues emerging as a primary cause of morbidity and mortality. Remarkably, the intricate association between CKD and left ventricular dysfunction (LVD) has not been extensively investigated in the context of African pediatric populations. This study attempts to close this gap. Method: This cross‐sectional study aimed to evaluate the prevalence of LVD using 2D echocardiography in pediatric patients diagnosed with CKD and identify associated factors. The study enrolled 95 CKD patients, all under 18, receiving care at the kidney follow‐up clinic of Tikur Anbessa Specialized Hospital, Ethiopia. Results: Analysis indicated that 55.8% of participants were male, while 44.2% were female. The leading cause of CKD was congenital anomalies of the kidney and urinary tract (CAKUT), accounting for 68.4% of cases. Among CKD cases, 42% were at Stages 2 and 3. Systolic and diastolic hypertension were present in 23.2% and 31.6% of the patients, respectively. Concentric remodeling was observed in 64%, while 10.6% showed concentric hypertrophy. Diastolic dysfunction was found in 20.4%, and only 3.2% had a low ejection fraction. Anemia was the sole factor significantly associated with cardiac dysfunction. The mean relative wall thickness was lower in those with anemia. The left ventricular mass index (LVMI) is strongly correlated (Pearson correlation coefficient of 0.764) with diastolic dysfunction. Conclusion: Most of the children with CKD had evidence of cardiac remodeling. Diastolic dysfunction was the most common type of functional cardiac impairment, as opposed to systolic dysfunction. Anemia was associated with a higher relative incidence of diastolic dysfunction. LVMI was the echocardiography parameter that was strongly correlated with diastolic dysfunction.