title: Children with chronic renal disease undergoing dialysis or conservative treatment--differences in structural and functional echocardiographic parameters.
abstract: Cardiac disease frequently occurs in children with chronic kidney disease (CKD) undergoing dialysis (DI), but it is not well studied in patients undergoing conservative treatment (CT). The aim of our study was to use echocardiography to analyze and compare the cardiac involvement of children with CKD undergoing DI or CT.
  
  
  METHODS
  Seventy-one children with CKD were included; 41 undergoing DI and 30 undergoing CT. There were 33 controls. Measurements of arterial pressure and structural and functional echocardiographic variables were obtained; the children were followed up for 18 months. Tests of comparison and multiple regression were used; significant if P < 0.05.
  
  
  RESULTS
  Arterial hypertension (AH) was present in 37 of 71 (52%) children with CKD: 27 (65.8%) in DI and 10 (33.3%) in CT (X2 = 8.7; P = 0.003). An abnormal left ventricular geometric pattern was present in 37/41 (90.3%) undergoing DI, 33 had left ventricular hypertrophy (LVH), and in 14/30 (46.7%) undergoing CT, 5 had LVH. Ejection fraction was normal in all groups; diastolic function alteration (DFA) occurred in 28/41 (68.3%) children on DI and in 10/30 (33.3%) on CT (X2 = 9.2; P = 0.002). For children with CKD, DI (P = 0.002) and hypertension (P = 0.04) were associated with LVH; among those on DI, only AH was associated with LVH (P = 0.02). During the follow-up, 18 (43.9%) children undergoing DI had at least one cardiovascular event.
  
  
  CONCLUSIONS
  Children with CKD undergoing CT had less cardiac involvement than those undergoing DI. LVH was associated with DI and AH in all children with CKD and with AH in those on DI.
authors: Valeska Tavares
authors: VT
authors: Scavarda
authors: Aurelio Carvalho
authors: AC
authors: Pinheiro
authors: Symône Damasceno
authors: SD
authors: Costa
authors: Zélia Maria
authors: ZM
authors: de Andrade
authors: João Tomás de Abreu
authors: JT
authors: Carvalhaes
authors: Orlando
authors: O
authors: Campos
authors: Antonio Carlos
authors: AC
authors: Carvalho
authors: Valdir Ambrosio
authors: VA
authors: Moises
mesh_terms: D000704:Analysis of Variance; D001794:Blood Pressure; D002648:Child; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D006973:Hypertension / Q000150:complications*; D017379:Hypertrophy, Left Ventricular / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D006435:Renal Dialysis / Q000379:methods*; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000628:therapy*