Impact of peritoneal transport characteristics on cardiac function in paediatric peritoneal dialysis patients: a Turkish Pediatric Peritoneal Dialysis Study Group (TUPEPD) report.
BACKGROUND
The peritoneal equilibration test (PET) is recommended in paediatric peritoneal dialysis (PD) patients to assist prescription management. Despite contradictory reports, high transporter status is associated with reduced survival rate in adults. Since cardiac disease is one of the main causes of mortality in paediatric PD patients, we aimed to evaluate whether transport features have any effect on biochemical data and cardiac function in this group.


METHODS
One hundred and ten PD patients (13 +/- 5 years, PD vintage: 31 +/- 27 months) were enrolled into the study. Four-hour dialysate/plasma creatinine ratio was used for differentiating PET groups. Thirty-eight patients were high transporters, 29 were high-average transporters and 43 were low-average/low transporters. Echocardiography was performed in all subjects.


RESULTS
Age, PD vintage, dialysate glucose concentration, ultrafiltration volume, urine volume and blood pressure levels were similar in all PET groups. No biochemical or echocardiographic data (ejection fraction, fractional shortening, left ventricular mass index, myocardial performance index, power Doppler E/tissue Doppler E ratio reflecting diastolic function) were different among PET groups except lower albumin (P = 0.025) levels in high transporters and higher high-sensitivity C-reactive protein (P = 0.026) levels in high and high-average transporters compared to other transport groups.


CONCLUSIONS
Cardiac structural and functional abnormalities are highly prevalent among paediatric PD patients. Transport rates did not have a significant effect on biochemical parameters or cardiac structural/functional parameters. It might be suggested that being a high transporter does not provide a disadvantage in terms of atherogenic tendency and cardiac disease in paediatric PD patients. Oligoanuria, anaemia and hypertension were independent predictors of cardiac disease.
Deparment of Pediatric Nephrology, Gazi University, Ankara, Turkey. sevcan@gazi.edu.tr
Sevcan A
SA
Bakkaloglu
Arda
A
Saygili
Lale
L
Sever
Nejat
N
Aksu
Aytul
A
Noyan
Sema
S
Akman
Mesiha
M
Ekim
Beyza
B
Doganay
Nurdan
N
Yildiz
Figen
F
Akalin
Salim
S
Caliskan
Orhan D
OD
Kara
Ali
A
Duzova
Alper
A
Soylu
Semra
S
Atalay
D000293:Adolescent; D001692:Biological Transport / Q000502:physiology; D002318:Cardiovascular Diseases; D016022:Case-Control Studies; D002648:Child; D015150:Echocardiography, Doppler; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D010530:Peritoneal Dialysis / Q000379:methods*; D010537:Peritoneum / Q000503:physiopathology*; D012307:Risk Factors; D015996:Survival Rate; D014421:Turkey