title: Oxidative stress and cardiac dysfunction in children with chronic renal failure on regular hemodialysis.
abstract: The objective of this study was to evaluate cardiac function in children with end-stage renal disease (ESRD) on regular hemodialysis using speckle tracking echocardiography (STE) and correlate results with plasma glutathione level as a marker of oxidative stress.
  
  
  
  The study involved 30 children with ESRD and 30 healthy controls. The plasma glutathione and C-reactive protein (CRP) levels were measured, and cardiac function was evaluated using conventional echocardiography and STE.
  
  
  
  Plasma glutathione levels were significantly lower and CRP significantly higher in patients than in controls. Children with ESRD had significant systolic and diastolic cardiac dysfunctions detected by STE compared with controls. Conventional echocardiography failed to detect these dysfunctions. There was significant increase in left-ventricular relative wall thickness (LV-RWT) in patients, especially those with hypertension, compared with the control group. There was also significant impairment of LV and right-ventricular (RV) global longitudinal strain (GLS) and torsion; however, LV-GLS was significantly better in hypertensive than in normotensive patients. The degree of impairment in GLS and cardiac torsion negatively correlated with plasma glutathione levels.
  
  
  
  Significant oxidative stress was present in children with ESRD and was correlated with the degree of cardiac dysfunction detected early using the new cardiac imaging modality, STE.
authors.affiliation: Pediatric Department, Tanta University, Tanta, Al Gharbia, Egypt. mbelrem@hotmail.com.
authors.forename: Mohammed
authors.identifier: 0000-0002-7761-9536
authors.initials: M
authors.lastname: Al-Biltagi
authors.affiliation: Pediatric Department, Tanta University, Tanta, Al Gharbia, Egypt.
authors.forename: Osama A
authors.initials: OA
authors.lastname: Tolba
authors.affiliation: Pediatric Department, Tanta University, Tanta, Al Gharbia, Egypt.
authors.forename: Maher Ahmed Abd
authors.initials: MA
authors.lastname: ElHafez
authors.affiliation: Pediatric Department, Tanta University, Tanta, Al Gharbia, Egypt.
authors.forename: Ahmed Abd ElBasset
authors.initials: AA
authors.lastname: Abo-Elezz
authors.affiliation: Pediatric Department, Tanta University, Tanta, Al Gharbia, Egypt.
authors.forename: Eman Kamel
authors.initials: EK
authors.lastname: El Kady
authors.affiliation: Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
authors.forename: Sahar Mohey El-Din
authors.initials: SM
authors.lastname: Hazza
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D018384:Oxidative Stress; D011446:Prospective Studies; D006435:Renal Dialysis
keywords: End-stage renal disease; Glutathione; Oxidative stress; Speckle tracking echocardiography; Tissue Doppler