Abstract
Background: Echocardiographic detectable cardiac abnormalities were studied to provide a platform for future longitudinal and interventional studies of children with Chronic Kidney Disease (CKD) in the south- east region of Nigeria. Methods: A cross-sectional study of echocardiographic screening of children aged between 6 and 17 years with CKD and selected age and sex matched controls that were consecutively enrolled from the Pediatric nephrology clinic of the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria. Results: Of the 9,419 patients within the age group 6-17 years who were seen at UNTH during the period of the study, 24 had CKD, giving an incidence of approximately 5 new cases per million-child population per year and a prevalence of 18.4 per million children population with a mean age of 12.33 + 4.24 years. Lower mean ejection fraction (EFrac%) values and E/A (transmitral flow velocity ratio) ratio were documented in patients compared to controls (p<0.01). Echocardiographic detectable cardiac abnormalities occurred in 22 (91.7%) of the patients and in 4 (16.7%) of the controls (p<0.01). The most common abnormality was left ventricular hypertrophy in 12 patients (50.0%) with 8 (66.6%) of 12 children having eccentric and 4 (33.3%) having concentric hypertrophy. Conclusions: This study shows that echocardiographic detectable cardiac abnormalities in children with CKD in the sub-region, is comparable to those of the other parts of the world with eccentric hypertrophy being more prevalent than concentric hypertrophy.
Highlights
Chronic Kidney Disease (CKD) is a multi-systemic clinical condition characterized by an irreversible deterioration of renal function that gradually progresses to end-stage renal disease (ESRD)
Ethical Clearance was obtained from the Independent Hospital Research and Ethical Committee (IHREC) of the University of Nigeria Teaching Hospital (UNTH) and written informed consent and assent obtained from parents and patients where applicable
During the six-month period of the study, nine thousand, four hundred and nineteen (9,419) pediatric patients within the age group 6-17 years were seen at UNTH Children Emergency (CHER) and all the Pediatric Outpatient Clinics of the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, with twenty-four (24) cases of CKD seen, giving an incidence of approximately five (5) new cases per million-child population per year and the prevalence of 18.4 per million children populations with the mean age of 12.33 + 4.24 years
Summary
Chronic Kidney Disease (CKD) is a multi-systemic clinical condition characterized by an irreversible deterioration of renal function that gradually progresses to end-stage renal disease (ESRD). Especially in developed countries, CKD is a growing problem, with the associated cardiovascular disease contributing largely to the mortality [3,4]. Most of the patients in subSaharan Africa and other developing countries die because of lack of treatment for both CKD and the associated cardiovascular abnormalities [5,6]. Cardiovascular complications, with significant 2- dimensional echocardiographic (2D-ECHO) changes, have been shown by several studies to be a major cause of morbidity and mortality in CKD patients especially those on dialysis and post kidney transplant [10,11] (Figure 1). Echocardiographic detectable cardiac abnormalities were studied to provide a platform for future longitudinal and interventional studies of children with Chronic Kidney Disease (CKD) in the south- east region of Nigeria
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