Document Detail


Cardiac output and associated left ventricular hypertrophy in pediatric chronic kidney disease.
MedLine Citation:
PMID:  19048301     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A significant number of children with chronic kidney disease (CKD) have eccentric left ventricular hypertrophy (LVH), suggesting the role of preload overload. Therefore, we hypothesized that increased cardiac output (CO) might be a contributing factor for increased left ventricular mass index (LVMI) in these children. Patients aged 6-20 years with CKD stages 2-4 were enrolled. Echocardiograms were performed to assess LV function and geometry at rest and during exercise. Heart rate, stroke volume, and CO were also assessed at rest and during exercise. Twenty-four-hour ambulatory blood pressure (AMBP) monitoring was performed. Of the patients enrolled in this study, 17% had LVH. Increased stroke volume and CO were observed in patients with LVH compared to patients without LVH. Univariate analysis revealed significant positive associations between LVMI and CO, stroke volume, body mass index, pulse pressure from mean 24-h AMBP, and mean 24-h systolic BP load. No association with heart rate, age, parathyroid hormone, glomerular filtration rate, or anemia was observed. Only CO (beta = 1.98, p = 0.0005) was independently associated with increased LVMI in multivariate modeling (model R (2) = 0.25). The results of this study suggest that increased CO might predispose to increased LVMI in pediatric patients with CKD. Adaptations may be required to meet increased metabolic demand in these patients.
Authors:
Donald J Weaver; Thomas R Kimball; Phillip R Koury; Mark M Mitsnefes
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2008-12-02
Journal Detail:
Title:  Pediatric nephrology (Berlin, Germany)     Volume:  24     ISSN:  0931-041X     ISO Abbreviation:  Pediatr. Nephrol.     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-02-03     Completed Date:  2009-06-18     Revised Date:  2013-08-22    
Medline Journal Info:
Nlm Unique ID:  8708728     Medline TA:  Pediatr Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  565-70     Citation Subset:  IM    
Affiliation:
Division of Nephrology and Hypertension, Cincinnati Children's Medical Center, Cincinnati, OH 45229, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cardiac Output*
Child
Chronic Disease
Echocardiography
Exercise Test
Female
Humans
Hypertrophy, Left Ventricular / etiology*
Kidney Diseases / complications*,  physiopathology
Male
Multivariate Analysis
Regression Analysis
Grant Support
ID/Acronym/Agency:
2K12HD28827/HD/NICHD NIH HHS; K23 HL69296-01/HL/NHLBI NIH HHS; UL1 TR000077/TR/NCATS NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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