scholarly journals Towards cardiovascular risks in children with chronic kidney disease: a prospective cohort study

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1794
Author(s):  
Taghreed Fadhil Al-Doori ◽  
Abd El-Salam Dawood Al-Ethawi ◽  
Jessar Saleem Hasan ◽  
Ban Adil Al-Kaaby
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Prospective Cohort ◽  
Growth Parameters ◽  
Systolic Function ◽  
High Volume ◽  
Left Ventricular ◽  
Cardiovascular Risks ◽  
Valvular Calcification ◽  
Tertiary Teaching

Background:Children with chronic kidney disease (CKD) are at substantially high risk of morbidity and mortality from cardiovascular disease (CVD). Although this issue has been extensively studied in adults, little is known whether similar associations exist in the paediatric population. We therefore aimed to evaluate the cardiac structure and function in children with CKD, and investigate the factors that contribute to the development of CVD.Methods:A prospective cohort was established following 40 children with CKD treated in the nephrology unit at a high-volume, tertiary, teaching hospital and compared to age- and gender-matched controls of the same number.  We reviewed the patients’ medical records, assessed growth parameters, measured blood pressure, took blood samples, and performed echocardiography.Results:More than half of the CKD patients are hypertensive (N = 22; 55%) and were found to have a higher proportion of increased left ventricular mass index (LVMI) (75.5%; P = 0.001). In contrast, we did not find any significant association between CKD and both valvular calcification & left ventricular (LV) fractional shortening (FS) in children (P = 0.314). Furthermore, high LVMI is found to be correlated well with the following: anaemia, hypertension, CKD duration > one year, hyperparathyroidism, estimated glomerular filtration rate (eGFR) < 15ml/minute/1.73 m2and death (P < 0.05).Conclusions:Despite the fact that LV systolic function is preserved and valvular calcification is usually absent, left ventricular hypertrophy (LVH) is common in children with CKD. Hypertension, anaemia, hyperparathyroidism, as well as the severity and duration of renal impairment, are amongst the additional risk factors that predispose to LVH. We contribute this study to the growing information of the review articles regarding the association between CKD and CVD in paediatrics.

scholarly journals Cardiovascular Risk Factors and Chronic Kidney Disease—FGF23: A Key Molecule in the Cardiovascular Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Rika Jimbo ◽  
Tatsuo Shimosawa
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Fibroblast Growth Factor 23 ◽  
Left Ventricular ◽  
Cardiovascular Risks ◽  
Mineral And Bone Disorder ◽  
Promising Target ◽  
Increased Risk

Patients with chronic kidney disease (CKD) are at increased risk of mortality, mainly from cardiovascular disease. Moreover, abnormal mineral and bone metabolism, the so-called CKD-mineral and bone disorder (MBD), occurs from early stages of CKD. This CKD-MBD presents a strong cardiovascular risk for CKD patients. Discovery of fibroblast growth factor 23 (FGF23) has altered our understanding of CKD-MBD and has revealed more complex cross-talk and endocrine feedback loops between the kidney, parathyroid gland, intestines, and bone. During the past decade, reports of clinical studies have described the association between FGF23 and cardiovascular risks, left ventricular hypertrophy, and vascular calcification. Recent translational reports have described the existence of FGF23-Klotho axis in the vasculature and the causative effect of FGF23 on cardiovascular disease. These findings suggest FGF23 as a promising target for novel therapeutic approaches to improve clinical outcomes of CKD patients.

scholarly journals The prevalence of fragmented QRS and its relationship with left ventricular systolic function in chronic kidney disease

2019 ◽  
Vol 48 (4) ◽  
pp. 030006051989079 ◽  
Author(s):  
Peng Liu ◽  
Jine Wu ◽  
Lu Wang ◽  
Dan Han ◽  
Chaofeng Sun ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Logistic Regression ◽  
Kidney Disease ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Multivariate Logistic Regression ◽  
Ventricular Systolic Function ◽  
Fragmented Qrs

Objective To investigate the prevalence of fragmented QRS (fQRS) on electrocardiograms (ECG) in patients with different stages of chronic kidney disease (CKD) and to examine the association between fQRS and left ventricular systolic function. Methods This retrospective study analysed clinical and laboratory data from consecutive patients with CKD. The relationship between fQRS and left ventricular systolic function was evaluated using univariate and multivariate logistic regression analyses. Results A total of 310 patients (186 males; mean ± SD age, 52.24 ± 15.72 years) with CKD participated in this study. The prevalence of fQRS was 30.32% (94 of 310 patients). The prevalence of fQRS was more common in the inferior leads (53.19%; 50 of 94) compared with the anterior leads (21.28%; 20 of 94) and the lateral leads (25.53%; 24 of 94). Multivariate logistic regression analysis showed that left ventricular ejection fraction (odds ratio [OR] 1.356; 95% confidence interval [CI] 1.022, 2.036) and coronary artery disease (OR 2.355; 95% CI 1.056, 5.251) were independent risk factors of fQRS in patients with CKD. Conclusion The fQRS was prevalent in patients with CKD regardless of the CKD stage.

scholarly journals Determinants of Mortality in Patients with Chronic Kidney Disease Undergoing Percutaneous Coronary Intervention

2016 ◽  
Vol 6 (3) ◽  
pp. 169-179 ◽  
Author(s):  
Alexandros Papachristidis ◽  
Wei Yao Lim ◽  
Christos Voukalis ◽  
Salma Ayis ◽  
Christopher Laing ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Percutaneous Coronary Intervention ◽  
Kidney Disease ◽  
Systolic Function ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Percutaneous Coronary ◽  
Ckd Stage

Background: Renal impairment is a known predictor of mortality in both the general population and in patients with cardiac disease. The aim of this study was to evaluate factors that determine mortality in patients with chronic kidney disease (CKD) who have undergone percutaneous coronary intervention (PCI). Methods: In this study we included 293 consecutive patients with CKD who underwent PCI between 1st January 2007 and 30th September 2012. The primary outcome that we studied was all-cause mortality in a follow-up period of 12-69 months (mean 38.8 ± 21.7). Results: Age (p < 0.001), PCI indication (p = 0.035), CKD stage (p < 0.001) and left ventricular ejection fraction (p < 0.001) were significantly related to mortality. CKD stage 5 [hazard ratio (HR) = 6.39, 95% CI: 1.51-27.12) and severely impaired left ventricular function (HR = 4.04, 95% CI: 2.15-7.59) were the strongest predictors of mortality. Other factors tested (gender, hypertension, diabetes, hyperlipidaemia, established peripheral vascular disease/stroke, coronary arteries intervened, number of vessels treated, number of stents implanted and length of lesion treated) did not show any correlation with mortality. Conclusions: The mortality of patients with CKD undergoing PCI increases with age, worsening CKD stage and deteriorating left ventricular systolic function, and it is also higher in patients with acute coronary syndromes compared to those with stable coronary artery disease.

scholarly journals P315 Prevalence of left ventricular systolic and diastolic dysfunction in patients with chronic kidney disease and preserved left ventricular ejection fraction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
O V Tereshina ◽  
O A Germanova ◽  
L A Rogozina ◽  
I L Davydkin
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Ejection Fraction ◽  
Diastolic Function ◽  
Circumferential Strain ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Ckd Stage ◽  
Lv Systolic Function

Abstract BACKGROUND Presence of heart failure (HF) is associated with poor outcome in patients with chronic kidney disease (CKD), although Left ventricular (LV) systolic function is often preserved in them. However, CKD patients may have HF symptoms with preserved LVEF. Myocardial Deformation Imaging is more accurate for detecting LV systolic dysfunction. The aim of this study was to evaluate global longitudinal (GLS) and circumferential strain (GCS) in patients with renal function impairment. METHODS Overall, 67 patients (40% men, mean age 45 ± 12 years) with CKD stage 3-4 were studied. All patients had an LV ejection fraction ≥50%. We performed echocardiography including speckle-tracking (STE) measurement of LV GLS and LV GCS and as well as assessment of diastolic function. RESULTS Despite preserved LVEF, impaired LV GLS (&lt;18%) was observed in all patients. The mean value of GLS was 14,1 ± 1,5. This finding indicates that systolic dysfunction in CKD started from compromise LV longitudinal function. However, the GCS parameter was in the normal range – 22,7 ± 1,8. Thereby preserved LVEF was compensated by normal or slightly increase circumferential strain. Impaired diastolic function was observed in 18% of patients including 8% patients with increased left ventricle filling pressure (stage II-III). CONCLUSION The prevalence of impaired LV GLS despite preserved LVEF in patients with CKD stage 3-4 is high, which proved that renal disease is associated with early and subclinical impairment of LV systolic function. Impaired diastolic function was not so common among them. Assessment of it is not always so easy and reliable using current recommendation. Thus, STE can be recommended for early detection impairment of LV function.

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