Anemia e hipoalbuminemia como factores de riesgo de disfunción diastólica del ventrículo izquierdo en niños con insuficiencia renal crónica tratados con diálisis peritoneal.

García-Bello, J. Antonio; Ortiz-Flores, Joel; Torres De La Riva, Francisco E.; Mendoza-Moreno, G. Karina; Gómez-Tenorio, Circe

Introduction: Left ventricular diastolic dysfunction (LVDD) is an independent predictor of mortality in Chronic Kidney Disease (CKD). The increase in the E/e' ratio is an indicator of LVDD. The association between cardiovascular risk factors (CVRFs) and E/e' in children with automated peritoneal dialysis (APD) has not been widely studied. Objective: To measure the association between CVRFs and E/e' in children with CKD on APD. Methods: Cross-sectional, prolective, observational, analytical study of children aged 6-16 years on APD. We recorded age, gender, time since onset, time on dialysis, and measured weight, height, blood pressure, hemoglobin, albumin, calcium, phosphorus, parathyroid hormone, and C-reactive protein. E/e' ratio was measured and considered to have increased when it was higher than 15. Results: Twenty-nine children were studied, (19 females). Age was 14.0 ± 2.5 years, and 16.9 ± 11.2 months with substitutive therapy. One patient had reduced left ventricular ejection fraction, and 21 (72.4%) had increased E/e'. E/e' correlated significantly with hemoglobin (r = -0.53, P = .003). Hemoglobin and albumin were significantly lower (9.72 ± 1.9 vs. 12.2 ± 1.8; P = .004 and 3.6 ± 0.5 vs. 4.0 ± 0.3; P = .035) and the proportion of patients with anemia and hypoalbuminemia was significantly higher (85.7% vs. 37.5%; P = .019 and 61.9% vs. 12.5%; P = .035) in patients with increased E/e'. Hemoglobin was the only independent predictor of E/e' (β = -0.66; P = .020) and patients with anemia were 10 times more likely to have increased E/e' (95% CI 1.5-65.6, P = .016). Conclusions: 75% of the children had increased E/e'. Anemia and hypoalbuminemia were significantly related with an increased E/e'.

LEFT heart ventricle diseases; KIDNEY diseases; CARDIOVASCULAR diseases; CHRONIC diseases; DIASTOLE (Cardiac cycle)

Nefrologia, 2018, Vol 38, Issue 4, p414

0211-6995

Academic Journal

10.1016/j.nefro.2017.11.024