Assessment of left ventricular function by tissue Doppler echocardiography in pediatric chronic kidney disease

Figures & data

Table 1. Clinical characteristics of the patients and control group.

	Controls	Group 1	Group 2	Total cohort	p
Parameters	(n = 16)	(n = 24)	(n = 19)	(n = 43)
Male/female	7/9	16/8	10/9	26/17	0.190
Age (year)	11.2 ± 3.0	12.7 ± 3.5	11.3 ± 3.2	12.3 ± 3.3	0.237
Height (cm)	139.0 ± 16.4	145.6 ± 17.5	135.6 ± 16.4	141.9 ± 16.9	0.960
BMI (kg/m^2)	18.8 ± 2.3	18.7 ± 5.0	18.2 ± 5.7	18.5 ± 5.3	0.283
Casual SBP (mmHg)	102.2 ± 14.4	101.6 ± 10.5	107.3 ± 10.9	104.2 ± 10.9	0.872
Casual DBP (mmHg)	60 ± 12.6	62.5 ± 9.4	63.6 ± 7.6	63.0 ± 8.6	0.949
Hypertension (n, %)	–	7 (29.2)	9 (47.4)	16 (37.2)	0.220
Antihypertensive use (n, %)	–	7 (29.2)	9 (47.4)	16 (37.2)
Phosphate binders (n, %)	–	12 (50.0)	16 (84.2)	28 (65.1)
Calcitriol use (n, %)	–	1 (4.2)	5 (26.9)	6 (14)
Erythropoietin use (n, %)	–	1 (4.2)	5 (26.9)	6 (14)

Notes: BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure.

Table 2. Biochemical data of the patients and control group.

	Controls	Group 1	Group 2
Parameters	(n = 16)	(n = 24)	(n = 19)	p
Hemoglobin (g/dL)	12.6 ± 0.9	12.7 ± 1.4	11.2 ± 1.5^a,b	0.001
Albumin (g/L)	4.5 ± 0.2	4.4 ± 0.5	4.4 ± 0.4	0.655
Hs-CRP (mg/L)	0.03 (0.02–0.04)	0.05 (0.02–0.12)	0.09 (0.02–0.51)	0.149
PTH (pg/mL)	37.5 (28.5–43.7)	58.0 (34.5–80.5)^a	137 (96–247)^a,b	<0.001
Serum Ca (mg/dL)	9.5 ± 0.4	9.5 ± 0.5	9.4 ± 0.8	0.888
Serum P (mg/dL)	4.4 ± 0.4	5.2 ± 0.7^a	5.4 ± 1.0^a	0.001
CaxP product (mg2/dL^2)	42.2 ± 4.8	49.9 ± 7.3^a	51.3 ± 9.4^a	0.001
Serum 25 (OH)D (pg/mL)	31 (23.2–41.7)	21.5 (16.7–28.0)^a	15 (7–24)^a,b	<0.001
Serum 1,25(OH)2D (pg/mL)	10.5 (6.7–15.1)	8.2 (4.9–13)	6.4 (3.6–12.2)	0.644
Triglycerides (mg/dL)	104.4 ± 32.7	141.6 ± 74.9	143.6 ± 61.5	0.118
Total cholesterol (mg/dL)	150.7 ± 11.7	166.9 ± 32.3^a	189.6 ± 55.9^a	0.014
LDL cholesterol (mg/dL)	86.4 ± 15.7	91.3 ± 27.6	111.7 ± 44.7^a	0.045
HDL cholesterol (mg/dL)	45.2 ± 6.7	47.2 ± 13.3	49.2 ± 11.5	0.588
eGFR (mL/min/1.73 m^2)	112 ± 3.2	57.5 ± 14.2	25.0 ± 4.6^a,b	<0.001

Notes: Hs-CRP, high-sensitivity C reactive protein; PTH, parathyroid hormone; Ca, calcium; P, phosphate; 25 (OH)D, 25 hydroxy vitamin D; 1,25(OH)₂D, 1,25 dihydroxy vitamin D; LDL cholesterol, low-density lipoprotein cholesterol; HDL cholesterol, high-density lipoprotein cholesterol; eGFR, estimated glomerular filtration rate.

Data are presented as the mean ± SD or the median (interquartile range, IQR) as appropriate.

p Values are for comparison across all groups obtained from ANOVA or Kruskal--Wallis.

^aSignificant difference with control patients; group 1 and group 2 were compared separately with controls by Tukey's post-hoc test or Mann--Whitney U test.

^bSignificant difference with group 1 patients; group 2 was compared with group 1 by Tukey's post-hoc test or Mann--Whitney U test.

Table 3. Echocardiographic findings of patients and controls.

	Controls	Group 1	Group 2
Parameters	(n = 16)	(n = 24)	(n = 19)	p
LV structure
LVMI (g/m^2.7)	33.1 ± 2.8	37.8 ± 6.6^a	43.0 ± 14.9^a	0.012
LVH (n, %)	–	8 (33.3)	11 (57.9)	0.107
RWT	0.3 ± 0.04	0.4 ± 0.09^a	0.4 ± 0.1^a	0.001
LV geometry (n, %)
Normal	17 (100)	14 (58.4)	3 (15.8)
Concentric LVH	–	8 (33.3)	5 (26.3)
Eccentric LVH	–	–	6 (31.6)
Concentric remodelling	–	2 (8.3)	5 (26.3)
LV systolic function
EF (%)	71.5 ± 5.9	72.0 ± 5.9	73.4 ± 6.4	0.79
FS (%)	40.5 ± 4.8	40.8 ± 5.1	42.0 ± 5.5	0.76
S′ (cm/s)	8.93 ± 1.48	8.87 ± 1.94	8.63 ± 2.03	0.88
LV diastolic function
E/A	2.12 ± 0.48	1.8 ± 0.8	1.7 ± 0.5	0.09
E′/A′	2.70 ± 0.68	2.37 ± 0.83	2.22 ± 0.66	0.18
E′ (cm/s)	17.93 ± 1.98	16.04 ± 2.54^a	14.21 ± 3.22^a	0.001
E/E′	5.66 ± 0.88	5.65 ± 1.18	7.10 ± 1.81^a,b	0.001

Notes: LV structure, left ventricular structure; LVMI, left ventricular mass index; RWT, relative wall thickness; LVH, left ventricular hypertrophy; EF, ejection fraction; FS, fractional shortening; S′, peak systolic velocity; E, peak of early diastolic flow velocities; A, peak of late diastolic flow velocities; E′, early diastolic peak filling velocity; A′, late diastolic peak filling velocity.

Data are presented as the mean ± SD or the median (interquartile range, IQR) as appropriate.

p Values are for comparison across all groups obtained from ANOVA or Kruskal--Wallis.

^aSignificant difference with control patients; group 1 and group 2 were compared separately with controls by Tukey's post-hoc test or Mann--Whitney U test.

^bSignificant difference with group 1 patients; group 2 was compared with group 1 by Tukey's post-hoc test or Mann--Whitney U test.

Gruppen MP, Groothoff JW, Prins M, et al. Cardiac disease in young adult patients with end-stage renal disease since childhood: A Dutch cohort study. Kidney Int. 2003;63:1058–1065

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