ESPN 53rd Annual Meeting

ESPN 2021


 
The Effect of Chronic Kidney Disease on Arterial Elasticity in Pediatric Population
ŞULE ARICI 2 ECE DEMIRCI BODUR 1 ÖZLEM SARISOY 3 OĞUZHAN TEZEL 4 HARIKA ALPAY 1 FIGEN AKALIN 2

1- MARMARA UNIVERSITY PEDIATRIC NEPHROLOGY
2- MARMARA UNIVERSITY PEDIATRIC CARDIOLOGY
3- ÜMRANIYE RESEARCH AND TRAINING HOSPITAL PAEDIATRIC CARDIOLOGY
4- MARMARA UNIVERSITY PAEDIATRICS
 
Abstract:

Objectives: Chronic kidney disease (CKD) can cause atherosclerosis and cardiac diseases. Echocardiographic measurement of the elasticity and distensibility of the aorta is useful in detecting early vascular changes. These measurements may be affected by dialysis efficiency and fluid load. In our study, we aimed to evaluate arterial functions by echocardiography in patients with CKD and investigate its relationship with clinical findings and bioimpedance measurements which are indicators of hydration status.

Materials and Methods: Twenty six patients with CKD followed-up in our Pediatric Nephrology and Cardiology outpatient clinics were evaluated for aortic elasticity. Demographic, clinical and laboratory findings, echocardiographic measurements, 24-hour ambulatory blood pressure values, bioimpedance measurements were recorded. Aortic strain, distensibility, aortic stiffness index were compared by a correlation analysis with CKD duration, dialysis time and type, overhydration status (bioimpedance analysis), systolic and diastolic blood pressures, hemoglobin and creatinine levels. A p value of <0.05 was considered statistically significant.

Results: Ten patients (38.5%) were female. Mean age was 13.5±3.6 years, CKD duration was 4.9±3.2 years. Sixteen patients (61.5%) were pre-dialysis patients, 10 patients (38.5%) were on renal replacement therapy. The systolic and diastolic blood pressures of the patients were 121.13 ± 11.27 mmHg and 79.07 ± 12.57 mmHg, respectively. Mean hemoglobin levels were 11.54 ± 2.22 g/dl, mean creatinine levels were 4.33 ± 3.09 mg/dl. Left ventricular functions were normal in all of the patients. Aortic valve pathology was detected in 3 patients. Ascending aorta stiffness index, strain and distensibility were 8,26±9,67,-1,62±1,15, 0,47±0,57 respectively. A positive correlation between CKD duration and stiffness of aorta was found (p values were 0,039 and 0,030 for arcus aorta and abdominal aorta respectively). No correlation was found between overhydration, blood pressure, hemoglobin, creatinine levels and aortic strain, distensibility, stiffness index.

Conclusion: We found that the duration of CKD and the deterioration in arterial functions were parallel. CKD may accompany aortic valve pathologies. Evaluation of arterial functions in the long-term follow-up will be useful for patients with CKD.