title: [Preliminary assessment of heart function in chronically dialysed children].
abstract: Renal replacement therapy has become a recognized treatment modality of children with chronic renal failure (CRF). Despite of unquestionable progress in heamodialysis treatment quite high morbidity and mortality still remain a serious problem among pediatric patients. The most common cause of death in haemodialyzed and transplanted patients are cardiovascular complications. The main aim of the study was an echocardiographic (ECHO) assessment of selected cardiac parameters in heamodialyzed children.
  
  
  METHODS
  16 chronically dialyzed (6 HD, 10 PD) children participated in the study (10 M, 6 F), aged 5-18,5 yrs (x=12.2 +/- 3.8 yrs). Echocardiography examinations were carried out with HP 5500 device and S4 ultrasound probe of variable frequency. Diastolic and systolic LV dimension, ejection fraction (EF) and LV mass index (LVMI) were evaluated. By means of pulsating Doppler method mitral flow peak E and A velocity and isovolumetric relaxation time (IRT) were assessed.
  
  
  RESULTS
  On the basis of ECHO examinations 3 groups were singled out: A (n=3) of normal heart function, B (n=3) of impaired systolic and diastolic heart function and C (n=10) of normal systolic and impaired diastolic heart function. In group of children with severe cardiac lesion (B group) a higher LV mass (A vs B vs C: 74.7 vs 119.9 vs 73.5 g/m2) and statistically significant lower ejection fraction (68.1 vs. 33.7 vs. 65.9%) were ascertained. These children were anuric (996 vs. 0 vs. 1112 mild), their systolic (102.1 vs. 118.4 vs. 117,9) and diastolic (64,4 vs. 84.8 vs. 77.9) blood pressure were significantly higher, so was the number or hipotensive medications (0.33 vs. 1.72 vs. 1,44).
  
  
  CONCLUSIONS
  The great majority of chronically dialyzed children demonstrates an impairment of cardiac function mainly of diastolic parameters. Anuria and hypertension stand for a significant risk factor of cardiac lesion.
authors.affiliation: Klinika Nefrologii Dzieciecej USD, Kraków. dadrozdz@cm-uj.krakow.pl
authors.forename: Dorota
authors.initials: D
authors.lastname: Drozdz
authors.forename: Andrzej
authors.initials: A
authors.lastname: Rudziński
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Kordon
authors.forename: Maciej
authors.initials: M
authors.lastname: Drozdz
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Zachwieja
authors.forename: Jacek A
authors.initials: JA
authors.lastname: Pietrzyk
authors.forename: Monika
authors.initials: M
authors.lastname: Miklaszewska
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Dziedzic
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000209:etiology; D006334:Heart Function Tests; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D006435:Renal Dialysis / Q000009:adverse effects; D012307:Risk Factors; D014463:Ultrasonography; D018754:Ventricular Dysfunction / Q000000981:diagnostic imaging* / Q000209:etiology