Evaluation of echocardiographic abnormalities in children with end-stage renal disease (CKD stage 5): A single-center experience

Abstract

BackgroundChronic Kidney disease (CKD) stage V might gradually induce the occurrence of morphological and functional cardiac disturbances; these cardiac disturbances make up supplementary risk factors. ObjectiveThe study aimed to describe electrocardiographic (ECG) and Echocardiographic (Echo) findings in dialysis patients. Also, to define the correlation between Echo findings and dialysis modality. MethodsWe studied 27 dialysis patients aged 3 years and one month to 25 years (163 ± 77 months. Boys accounted for 59.3 % of the patients. The modality of dialysis was peritoneal dialysis (PD) in 33.3 % and hemodialysis (HD) in 51.9 % of cases. Four patients (14.8 %) had undergone both modalities at different times. All patients were taken ECG and Doppler 2D echocardiography (Echo). Assessment of LV systolic function was done according to ejection fraction (EF) and categorized as normal (≥55 %), mild systolic dysfunction (45–54 %), moderate systolic dysfunction (30–44 %), and severe systolic dysfunction (<30 %) . ResultsThe most common abnormalities in ECG were left ventricular hypertrophy (70.4 %), prolonged QTC interval (33.3 %), and first-degree atrioventricular block (25.9 %), respectively. Based on the ejection fraction, 40.7 %, 33.3 %, and 26 % of the patients had normal systolic function, mild systolic dysfunction, and moderate systolic dysfunction, respectively. Also, left ventricular (LV) volume in both diastole and systole were significantly lower in PD compared to HD cases (P = 0.006 and 0.004). ConclusionsWe found that abnormal findings in ECG are common among pediatric dialysis patients. Additionally, Echo's assessment noted that systolic dysfunction was common. Significantly lower LV volume in diastole and systole in PD compared to HD cases may suggest that PD patients encounter less pressure and volume loads. These findings can be considered a positive point of PD modality.