Echo-Cardiographic Problems in CKD in Children

Abstract

BACKGROUND:Left -ventricular hypertrophy, Changes in vascular architecture, myo-cardial calcifications are main (structural abnormalities) of the heart that have been described in patients with (chronic kidney disease) and are the most common cause of(( mortality )).OBJECTIVE: To highlight ((Echo- cardiographic )) findings in children with different stages of chronic kidney disease (CKD) and (risk factors ) associated with abnormal echo findings.PATIENTS AND METHODS: A ((prospective study)), consist of 50 patients with chronic kidney disease, age ranged between (6 months - 14 years) admitted to ((nephrology- unit)) in children welfare teaching hospital in ((Medical- City complex)) during the period from (1st of Jul. 2019 to 30th of Jul. 2020) were included in the study. Detailed-history was taken, complete -physical examination, biochemical- investigations, Abdominal Ultra-sound, Chest- X Ray and Echo-cardiography- were done to all patients enrolled in the study.RESULTS: The study included 29 (58%) male and 21 (42%) female, with (male: female ratio was1.4 : 1), The most common cause of CKD was renal abnormalities 25 (50%) most of them were ((reflux nephropathy and neurogenic bladder)).The most common abnormal Echo findings was (left -ventricular- hypertrophy) in 16 (32 %) of patients. There were no significant association between Echo findings and different stages ( III , IV , V ) of chronic kidney disease ( p > 0.05 ). There were significant association between (((abnormal Echo findings))) and some risk factors like- anemia and hypertension ( p ≤ 0.05 ).CONCLUSION: The most common cause of chronic kidney disease (CKD) was (((congenital renal abnormalities))) in which reflux -nephropathy and neurogenic- bladder is commonest. Echo-cardiogram reveal abnormal finding in 50% of children with CKD, most common abnormal echo finding was left ventricular hypertrophy (LVH). Anemia and hypertension were the most common risk factors that are associated with abnormal echo findings.