Key result
Pediatric primary nephrotic syndrome is linked to subclinical RV dysfunction, especially in steroid-resistant disease.
Why the study?
Few studies have investigated right ventricle function in children with primary nephrotic syndrome despite known systemic effects impacting cardiac function.
Does primary nephrotic syndrome alter right ventricular function in children compared to healthy controls?
Case-Control (n=80)
No
Does primary nephrotic syndrome alter right ventricular function in children compared to healthy controls?
Integrative multimodal echocardiography reveals subclinical right ventricular systolic and diastolic alterations in children with primary nephrotic syndrome, particularly those with steroid-resistant disease, suggesting a need for routine cardiac surveillance.
Answers are grounded in this paper and cite their sources.
Suggests echocardiographic surveillance may be considered in pediatric primary nephrotic syndrome; leaves open clinical impact pending prospective validation.
BACKGROUND: Primary nephrotic syndrome (NS) is associated with systemic effects that may impact cardiac function, although several studies have explored left ventricle in children with NS. Few studies investigated right ventricle (RV) in this disease. Therefore, the study aimed to provide a comprehensive evaluation of RV functions in children with primary NS using echocardiography. METHODS: A case-control observational study was conducted from January 2022 to August 2024 on 40 primary NS patients with steroid-resistant nephrotic syndrome (SRNS) and steroid-sensitive nephrotic syndrome (SSNS), alongside 40 healthy controls. All participants underwent RV assessments using conventional parameters, tissue Doppler imaging (TDI), two-dimensional speckle-tracking echocardiography (2D STE), and three-dimensional echocardiography (3DE). RESULTS: Significantly lower s', e' in NS patients compared to controls, especially lower in SRNS compared to SSNS. Significantly higher E/e' and Tei index was detected in the NS group compared to controls (p = < 0.001) and more pronounced in SRNS. RV free wall strain longitudinal strain (RVFWLS) and RV four chamber longitudinal strain (RV4CSL) were significantly reduced in NS group compared to controls. 3D auto RV-derived ejection fraction (EF), TAPSE, stroke volume and septal strain were lower in NS compared to controls(p = < 0.001); however, there are no significant differences between SSNS and SRNS. Significant correlations were detected between some echocardiographic parameters and serum cholesterol, albumin, and creatinine. CONCLUSIONS: Integrative use of variable echocardiographic modalities allows detection of subclinical alterations in RV function in children with primary NS, with more affected parameters in SRNS. Therefore, regular surveillance of RV functions in primary NS should be considered.
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Hussein et al. (2026) conducted a case-control in Primary Nephrotic Syndrome (n=80). Primary Nephrotic Syndrome (Steroid-Sensitive and Steroid-Resistant) vs. Healthy controls was evaluated on Right ventricular function assessed by multiple echocardiographic modalities (including 3D-derived ejection fraction and RV Tei index) (p=< 0.001). Primary nephrotic syndrome in children is associated with significant subclinical impairment of right ventricular function, including reduced 3D-derived ejection fraction and impaired global longitudinal strain, with alterations being more pronounced in steroid-resistant cases.
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