ESPN 50th Annual Meeting

ESPN 2017


 
RISK FACTORS OF LEFT VENTRICULAR MASS INCREASE IN CHILDREN WITH CHRONIC KIDNEY DISEASE
Dorota Drozdz 1 Przemko Kwinta 2 Andrzej Rudzinski 3 Monika Latka 1 Tomasz Drozdz 4 Krystyna Sztefko 5

1- Dpt. of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, Krakow, Poland
2- Dpt. of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
3- Dpt. of Pediatric Cardiology, Jagiellonian University Medical College, Krakow, Poland,
4- I Dpt. of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland
5- Dpt. of Clin. Biochemistry, Jagiellonian University Medical College, Krakow, Poland
 
Introduction:

Left ventricular hypertrophy (LVH) is a major risk factor of cardiovascular complications. The study aimed to identify risk factors that contribute to LVH progression in children with chronic kidney disease (CKD) during 1 year observation

Material and methods:

 The study was conducted in a group of 48 children (17 girls and 31 boys) with CKD stage 1 to 5. The patients’ mean age was 11 years and mean GFR was 32 ml/min/1.73m2. Serum creatinine, BNP, ADMA and oxyLDL levels were measured. Ambulatory blood pressure measurements (ABPM) were performed. Echocardiographic examinations were carried out with a HP 5500 device. The 95th percentile of LV mass index relative to height age was used to define LVH.

Results:

 LVH was detected in 22 children. There were no significant differences in biochemical parameters and blood pressure values between children with the progression vs regression of LVMI (change >15%). 26 children without LVH at first observation developed a LVMI increase of >15% during 12-month observation. In this group lower height (124.7 vs 134.4 cm; p=0.001) and significantly higher night blood pressure (BP) values were observed: systolic (100.0 vs. 96.8 mm Hg; p=0.024), diastolic BP (57.0 vs. 54.7 mm Hg; p=0.006) and mean arterial pressure (73.7 vs. 70.0 mm Hg, p=0.001). In addition, higher systolic, diastolic BP and MAP values in 24 hour measurements were found.

Conclusions:

 BNP concentration is not a predictive index of left ventricular hypertrophy. Night blood pressure is a significant risk factor of LVH development in children with chronic kidney disease. Regular ABPM measurements and intensive hypotensive treatment are important elements of cardioprotection.