Progression of left ventricular hypertrophy in children with early chronic kidney disease: 2-year follow-up study

J Pediatr. 2006 Nov;149(5):671-5. doi: 10.1016/j.jpeds.2006.08.017.

Abstract

Objective: To determine the prevalence and incidence of left ventricular hypertrophy (LVH) and LV geometry and identify variables associated with LV mass (LVM) growth and development of LVH in children and adolescents with chronic kidney disease (CKD).

Study design: A 2-year longitudinal study of children with CKD (glomerular filtration rate [GFR] 15-89 mL/minute/1.73 m2). Thirty-one subjects had baseline and repeated echocardiography.

Results: Six (19%) of 31 children had LVH at baseline; the prevalence of LVH increased to 39% at 2-year follow-up. Eccentric LVH was the most common geometric pattern throughout the study. Among 25 children with initially normal LVM index, 8 (32%) developed new LVH. Children with incident LVH had significantly higher mean parathyroid hormone (iPTH), lower hemoglobin and calcium levels at baseline, and significantly larger increase in iPTH during a follow-up than children with normal LVM index. Stepwise regression analysis showed that lower initial LVM index and hemoglobin level and interval increase in iPTH and nighttime systolic blood pressure (SBP) load during a follow-up independently predicted interval increase in LVM index.

Conclusions: LVH progresses in children during early stages of CKD. More aggressive control of anemia, BP, and hyperparathyroidism might be important in preventing the development of LVH in these patients.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Atrial Function
  • Biomarkers / blood
  • Blood Pressure
  • Child
  • Circadian Rhythm
  • Disease Progression
  • Echocardiography
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Hypertrophy, Left Ventricular / epidemiology
  • Hypertrophy, Left Ventricular / physiopathology*
  • Incidence
  • Kidney Failure, Chronic / diagnostic imaging
  • Kidney Failure, Chronic / epidemiology
  • Kidney Failure, Chronic / physiopathology*
  • Male
  • Predictive Value of Tests
  • Prevalence
  • Prospective Studies
  • Severity of Illness Index
  • Stroke Volume
  • Time Factors
  • Ventricular Function, Left

Substances

  • Biomarkers