Структура кардиоваскулярных нарушений у детей с хронической болезнью почек

Abstract

Objective. To study the structure of cardiovascular pathology in children with chronic kidney disease (CKD). Patients and methods. 74 children were examined, including 40 patients on dialysis and 34 patients at the predialysis stage of CKD. The following parameters were determined: the thickness of the interventricular septum and the posterior wall of the left ventricle (LV), the final systolic and final diastolic LV size, shock volume, ejection fraction. The myocardial mass index (LVMI) and the relative wall thickness (RWT) of the LV were calculated according to the following formulas. Results. According to echocardiography data in children receiving dialysis, LV myocardial hypertrophy was observed in the majority of children – 17 (42.5%, p < 0.001), of which in 35.3% of cases (6 children) concentric remodeling was detected (RWT ≥0.45, LVH within 90 g/m2), in 41.2% of cases (in 7 patients), concentric hypertrophy was determined (RWT ≥0.45, LVMI 111.7 ± 11.4 g/m2), eccentric hypertrophy was detected in 23.5% of patients (in 4 – RWT ≤0.45, IMLJ 115.6 ± 11.9 g/m2); systolic dysfunction was found in 10 (25%) children with stage 5d CKD, in 8 (20%) – diastolic dysfunction, in 5 (12.5%) – the valvular damage. In 19 (55.9%) children with the predialysis stage, there is a normal LV geometry (RWT <45 with normal LV), in 15 (44.1%) – concentric remodeling (RWT >45 with normal LVMI). Conclusion. CKD in children, as in adults, is associated with the highest risk of accelerated development of cardiovascular pathology. Cardiovascular pathology in CKD is manifested mainly by LV myocardial hypertrophy. LV hypertrophy, being an important risk factor for arrhythmias and heart failure, is especially characteristic of patients with dialysis for,m of CKD. Key words: cardiovascular disorders, chronic kidney disease