Electrocardiographic measurements in children with pre-dialysis chronic kidney disease and undergoing kidney replacement therapy.
Chronic kidney disease
Dialysis
Echocardiography
Electrocardiography
Kidney transplantation
Left ventricular hypertrophy
Journal
European journal of pediatrics
ISSN: 1432-1076
Titre abrégé: Eur J Pediatr
Pays: Germany
ID NLM: 7603873
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
25
04
2023
accepted:
07
08
2023
revised:
03
08
2023
medline:
13
11
2023
pubmed:
25
8
2023
entrez:
25
8
2023
Statut:
ppublish
Résumé
Cardiovascular diseases are the main causes of morbidity in children with chronic kidney disease (CKD). Electrocardiography (ECG) can provide important information about cardiac functions and parameters associated with sudden cardiac death. This study aims to evaluate the potentially dangerous changes in CKD and kidney replacement therapies by ECG and to determine the value of ECG in predicting cardiovascular outcome compared with echocardiography. 101 patients with CKD were divided into subgroups according to treatment modalities as pre-dialysis CKD, hemodialysis (HD), peritoneal dialysis (PD) and kidney transplantation (KTx). Differences in anthropometric measurements, laboratory results, blood pressures, ECG monitoring were compared within groups as well as with 40 healthy controls. Available echocardiographic findings were noted. In the patients, HD group had highest frequency of hypertension. ECG revealed prolonged QTc as more frequent (16.8% vs 0%, p = 0.006) and higher QTcD (56.7 ± 6.5 vs 39.9 ± 5.1 ms, p = 0.001) in the patients compared to controls, especially in dialysis patients, whereas lowest values were in KTx subgroup. Left ventricular (LV) hypertrophy (LVH) was more frequent (47.1%) in HD compared to other CKD subgroups in ECG (p = 0.052). Echocardiography also showed LV mass index as highest in HD and lowest in KTx (121.4 ± 55.7 vs 63.7 ± 18.3 g/m
Identifiants
pubmed: 37624446
doi: 10.1007/s00431-023-05154-2
pii: 10.1007/s00431-023-05154-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
4993-5005Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Webster AC, Nagler EV, Morton RL, Masson P (2017) Chronic kidney disease. Lancet 389:1238–1252. https://doi.org/10.1016/S0140-6736(16)32064-5
doi: 10.1016/S0140-6736(16)32064-5
pubmed: 27887750
Romagnani P, Remuzzi G, Glassock R et al (2017) Chronic kidney disease. Nat Rev Dis Primers 3:17088. https://doi.org/10.1038/nrdp.2017.88
doi: 10.1038/nrdp.2017.88
pubmed: 29168475
Harambat J, van Stralen KJ, Kim JJ, Tizard EJ (2012) Epidemiology of chronic kidney disease in children. Pediatr Nephrol 27:363–373. https://doi.org/10.1007/s00467-011-1939-1
doi: 10.1007/s00467-011-1939-1
pubmed: 21713524
Chen TK, Knicely DH, Grams ME (2019) Chronic kidney disease diagnosis and management: a review. JAMA 322:1294–1304. https://doi.org/10.1001/jama.2019.14745
doi: 10.1001/jama.2019.14745
pubmed: 31573641
pmcid: 7015670
Zhong J, Yang HC, Fogo AB (2017) A perspective on chronic kidney disease progression. Am J Physiol Renal Physiol 312:F375–F384. https://doi.org/10.1152/ajprenal.00266.2016
doi: 10.1152/ajprenal.00266.2016
pubmed: 27974318
Di Lullo L, House A, Gorini A, Santoboni A, Russo D, Ronco C (2015) Chronic kidney disease and cardiovascular complications. Heart Fail Rev 20:259–272. https://doi.org/10.1007/s10741-014-9460-9
doi: 10.1007/s10741-014-9460-9
pubmed: 25344016
Jardine GA, McLaughlin K (2001) Cardiovascular complications of renal disease. Heart 86:459–466. https://doi.org/10.1136/heart.86.4.459
doi: 10.1136/heart.86.4.459
pubmed: 11559693
pmcid: 1729948
Brown JH, Hunt LP, Vites NP, Shunt CD, Gokal R, Mallick NP (1994) Comparative mortality from cardiovascular disease in patients with chronic renal failure. Nephrol Dial Transpl 9:1136–1142. https://doi.org/10.1093/ndt/9.8.1136
doi: 10.1093/ndt/9.8.1136
Killian L, Simpson JM, Savis A, Rawlins D, Sinha MD (2010) Electrocardiography is a poor screening test to detect left ventricular hypertrophy in children. Arch Dis Child 95:832–836. https://doi.org/10.1136/adc.2009.168377
doi: 10.1136/adc.2009.168377
pubmed: 20656727
Panhuyzen-Goedkoop NM, Wellens HJ, Verbeek AL, Jørstad HT, Smeets JR, Peters RJ (2020) ECG criteria for the detection of high-risk cardiovascular conditions in master athletes. Eur J Prev Cardiol 27:1529–1538. https://doi.org/10.1177/2047487319901060
doi: 10.1177/2047487319901060
pubmed: 31996014
pmcid: 7469710
Alonso MAG, Lima VACC, Carreira MAMQ, Lugon JR (2017) Reproducibility and Reliability of QTc and QTcd measurements and their relationships with left ventricular hypertrophy in hemodialysis patients. Arq Bras Cardiol 109:222–230. https://doi.org/10.5935/abc.20170112
doi: 10.5935/abc.20170112
pubmed: 28793044
pmcid: 5586229
Neyzi O, Saka HN, Kurtoğlu S (2013) Anthropometric studies on the Turkish population, a historical review. J Clin Res Pediatr Endocrinol 5:1–12. https://doi.org/10.4274/Jcrpe.957
doi: 10.4274/Jcrpe.957
pubmed: 23419421
pmcid: 3628386
Turkish Pediatric Endocrinology and Diabetes Society (2017) Oksoloji. https://www.ceddcozum.com/Home/Change?%20Language%20Abbreviation=tr . Accessed 14 Oct 2022
Martinez-Millana A, Hulst JM, Boon M et al (2018) Optimisation of children z-score calculation based on new statistical techniques. PLoS ONE 13:e0208362. https://doi.org/10.1371/journal.pone.0208362
doi: 10.1371/journal.pone.0208362
pubmed: 30571681
pmcid: 6301782
Dietz WH, Robinson TN (1998) Use of the body mass index (BMI) as a measure of overweight in children and adolescents. J Pediatr 132:191–193. https://doi.org/10.1016/s0022-3476(98)70426-3
doi: 10.1016/s0022-3476(98)70426-3
pubmed: 9506622
Demir K, Konakçı E, Özkaya G et al (2020) New features for child metrics: further growth references and blood pressure calculations. J Clin Res Pediatr Endocrinol 12:125–129. https://doi.org/10.4274/jcrpe.galenos.2019.2019.0127
doi: 10.4274/jcrpe.galenos.2019.2019.0127
pubmed: 31475511
pmcid: 7291402
Anderson LN, Carsley S, Lebovic G et al (2017) Misclassification of child body mass index from cut-points defined by rounded percentiles instead of Z-scores. BMC Res Notes 10:639. https://doi.org/10.1186/s13104-017-2983-0
doi: 10.1186/s13104-017-2983-0
pubmed: 29183360
pmcid: 5706297
Subcommıttee on Screenıng and Management of High Blood Pressure in Children (2017) Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 140:e20171904. https://doi.org/10.1542/peds.2017-1904
doi: 10.1542/peds.2017-1904
Locatelli F, Nissenson AR, Barrett BJ et al (2008) Clinical practice guidelines for anemia in chronic kidney disease: problems and solutions. A position statement from kidney disease: Improving Global Outcomes (KDIGO). Kidney Int 74:1237–1240. https://doi.org/10.1038/ki.2008.299
doi: 10.1038/ki.2008.299
pubmed: 18596731
Schwartz GJ, Work DF (2009) Measurement and etimation of GFR in children and adolescents. Clin J Am Soc Nephrol 4:1832–1843. https://doi.org/10.2215/CJN.01640309
doi: 10.2215/CJN.01640309
pubmed: 19820136
Fadrowski JJ, Furth SL (2011) GFR estimation in children: questions and answers (and questions). Clin J Am Soc Nephrol 6:1810–1812. https://doi.org/10.2215/CJN.05900611
doi: 10.2215/CJN.05900611
pubmed: 21784827
Fleming S, Thompson M, Stevens R et al (2011) Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: a systematic review of observational studies. Lancet 377:1011–1018. https://doi.org/10.1016/S0140-6736(10)62226-X
doi: 10.1016/S0140-6736(10)62226-X
pubmed: 21411136
pmcid: 3789232
Rijnbeek PR, Witsenburg M, Schrama E, Hess J, Kors JA (2001) New normal limits for the paediatric electrocardiogram. Eur Heart J 22:702–711. https://doi.org/10.1053/euhj.2000.2399
doi: 10.1053/euhj.2000.2399
pubmed: 11286528
Bazett HC (1920) An analysis of the time relations of electrocardiograms. Heart 7:353–367
Garson A (1993) How to measure the QT interval-what is normal? Am J Cardiol 72:14B-16B. https://doi.org/10.1016/0002-9149(93)90034-a
doi: 10.1016/0002-9149(93)90034-a
pubmed: 8256749
Koçak G, Atalay S, Bakkaloglu S, Ekim M, Tutar HE, Imamoglu A (1999) QT/corrected QT (QTc) intervals and QT/QTc dispersions in children with chronic renal failure. Int J Cardiol 70:63–67. https://doi.org/10.1016/s0167-5273(99)00051-0
doi: 10.1016/s0167-5273(99)00051-0
pubmed: 10402047
Malik M, Batchvarov VN (2000) Measurement, interpretation and clinical potential of QT dispersion. J Am Coll Cardiol 36:1749–1766. https://doi.org/10.1016/s0735-1097(00)00962-1
doi: 10.1016/s0735-1097(00)00962-1
pubmed: 11092641
Peguero JG, Lo Presti S, Perez J, Issa O, Brenes JC, Tolentino A (2017) Electrocardiographic criteria for the diagnosis of left ventricular hypertrophy. J Am Coll Cardiol 69:1694–1703. https://doi.org/10.1016/j.jacc.2017.01.037
doi: 10.1016/j.jacc.2017.01.037
pubmed: 28359515
Devereux RB, Alonso DR, Lutas EM et al (1986) Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 57:450–458. https://doi.org/10.1016/0002-9149(86)90771-x
doi: 10.1016/0002-9149(86)90771-x
pubmed: 2936235
Furqan M, Haque A (2009) Surface area in children: a simple formula. Indian Pediatr 46:1085–1087
pubmed: 19430073
Khoury PR, Mitsnefes M, Daniels SR, Kimball TR (2009) Age-specific reference intervals for indexed left ventricular mass in children. J Am Soc Echocardiogr 22:709–714. https://doi.org/10.1016/j.echo.2009.03.003
doi: 10.1016/j.echo.2009.03.003
pubmed: 19423289
Mitsnefes MM (2012) Cardiovascular disease in children with chronic kidney disease. J Am Soc Nephrol 23:578–585. https://doi.org/10.1681/ASN.2011111115
doi: 10.1681/ASN.2011111115
pubmed: 22383696
pmcid: 3312513
Ku E, Lee BJ, Wei J, Weir MR (2019) Hypertension in CKD: Core Curriculum 2019. Am J Kidney Dis 74:120–131. https://doi.org/10.1053/j.ajkd.2018.12.044
doi: 10.1053/j.ajkd.2018.12.044
pubmed: 30898362
VanDeVoorde RG, Mitsnefes MM (2011) Hypertension and CKD. Adv Chronic Kidney Dis 18:355–361. https://doi.org/10.1053/j.ackd.2011.03.003
doi: 10.1053/j.ackd.2011.03.003
pubmed: 21896377
Alexandrou ME, Loutradis C, Schoina M et al (2020) Ambulatory blood pressure profile and blood pressure variability in peritoneal dialysis compared with hemodialysis and chronic kidney disease patients. Hypertens Res 43:903–913. https://doi.org/10.1038/s41440-020-0442-0
doi: 10.1038/s41440-020-0442-0
pubmed: 32327730
Lübbe K, Nüsken E, Rascher K et al (2019) Glomerular disease patients have higher odds not to reach quality targets in chronic dialysis compared with CAKUT patients: analyses from a nationwide German paediatric dialysis registry. Pediatr Nephrol 34:1229–1236. https://doi.org/10.1007/s00467-019-04218-6
doi: 10.1007/s00467-019-04218-6
pubmed: 30843113
Hallioglu O, Keceli M, Bozlu G, Delibas A, Karpuz D, Selvi H (2018) Evaluation of T-wave alternans in pediatric patients with chronic renal failure. J Electrocardiol 51:622–627. https://doi.org/10.1016/j.jelectrocard.2018.04.013
doi: 10.1016/j.jelectrocard.2018.04.013
pubmed: 29997001
Skampardoni S, Poulikakos D, Malik M, Green D, Kalra PA (2019) The potential of electrocardiography for cardiac risk prediction in chronic and end-stage kidney disease. Nephrol Dial Transplant 34:1089–1098. https://doi.org/10.1093/ndt/gfy255
doi: 10.1093/ndt/gfy255
pubmed: 30085289
Ohashi N, Isobe S, Ishigaki S et al (2019) Increased heart rate is associated with intrarenal renin-angiotensin system activation in chronic kidney disease patients. Clin Exp Nephrol 23:1109–1118. https://doi.org/10.1007/s10157-019-01746-1
doi: 10.1007/s10157-019-01746-1
pubmed: 31131423
Parisotto V, Lima EM, Silva JM, de Sousa MR, Ribeiro AL (2008) Cardiac sympathetic dysautonomia in children with chronic kidney disease. J Nucl Cardiol 15:246–254. https://doi.org/10.1016/j.nuclcard.2008.01.003
doi: 10.1016/j.nuclcard.2008.01.003
pubmed: 18371597
Converse RL Jr, Jacobsen TN, Toto RD et al (1992) Sympathetic overactivity in patients with chronic renal failure. N Engl J Med 327:1912–1918. https://doi.org/10.1056/NEJM199212313272704
doi: 10.1056/NEJM199212313272704
pubmed: 1454086
Festa A, D’Agostino R Jr, Rautaharju P, Mykkänen L, Haffner SM (2000) Relation of blood pressure, left ventricular mass, insulin sensitivity, and coronary artery disease to QT interval duration in nondiabetic and type 2 diabetic subjects. Am J Cardiol 86:1117–1122. https://doi.org/10.1016/s0002-9149(00)01170-x
doi: 10.1016/s0002-9149(00)01170-x
pubmed: 11074210
Williams MJ, Hammond-Tooke GD, Restieaux NJ (1995) Hypokalemic periodic paralysis with cardiac arrhythmia and prolonged QT interval. Aust N Z J Med 25:549. https://doi.org/10.1111/j.1445-5994.1995.tb01512.x
doi: 10.1111/j.1445-5994.1995.tb01512.x
pubmed: 8588789
Huang TC, Cecchin FC, Mahoney P, Portman MA (2000) Corrected QT interval (QTc) prolongation and syncope associated with pseudohypoparathyroidism and hypocalcemia. J Pediatr 136:404–407. https://doi.org/10.1067/mpd.2000.103447
doi: 10.1067/mpd.2000.103447
pubmed: 10700702
Bosch A, Ulmer HE, Keller HE, Bonzel KE, Schärer K (1990) Electrocardiographic monitoring in children with chronic renal failure. Pediatr Nephrol 4:140–144. https://doi.org/10.1007/BF00858825
doi: 10.1007/BF00858825
pubmed: 2397180
Butani L, Berg G, Makker SP (2002) QTc interval in children with chronic renal failure and with renal transplants. Pediatr Nephrol 17:6–9. https://doi.org/10.1007/s004670200001
doi: 10.1007/s004670200001
pubmed: 11793127
Vandael E, Vandenberk B, Vandenberghe J, Willems R, Foulon V (2017) Risk factors for QTc-prolongation: systematic review of the evidence. Int J Clin Pharm 39:16–25. https://doi.org/10.1007/s11096-016-0414-2
doi: 10.1007/s11096-016-0414-2
pubmed: 28012118
Barr CS, Naas A, Freeman M, Lang CC, Struthers AD (1994) QT dispersion and sudden unexpected death in chronic heart failure. Lancet 343:327–329. https://doi.org/10.1016/s0140-6736(94)91164-9
doi: 10.1016/s0140-6736(94)91164-9
pubmed: 7905146
Ducceschi V, Sarubbi B, Giasi A et al (1996) Correlation between late potentials duration and QTc dispersion: Is there a causal relationship? Int J Cardiol 53:285–290. https://doi.org/10.1016/0167-5273(96)02565-x
doi: 10.1016/0167-5273(96)02565-x
pubmed: 8793583
Akintunde AA, Oyedeji AT, Familoni OB, Ayodele OE, Opadijo OG (2012) QT Interval prolongation and dispersion: Epidemiology and clinical correlates in subjects with newly diagnosed systemic hypertension in Nigeria. J Cardiovasc Dis Res 3:290–295. https://doi.org/10.4103/0975-3583.102705
doi: 10.4103/0975-3583.102705
pubmed: 23233773
pmcid: 3516009
Familoni OB, Alebiosu CO, Ayodele OE (2006) Effects and outcome of haemodialysis on QT intervals and QT dispersion in patients with chronic kidney disease. Cardiovasc J S Afr 17:19–23
pubmed: 16547556
Ozdemir D, Mese T, Agin H, Calkavur S, Bak M (2005) Impact of haemodialysis on QTc dispersion in children. Nephrology (Carlton) 10:119–123. https://doi.org/10.1111/j.1440-1797.2005.00378.x
doi: 10.1111/j.1440-1797.2005.00378.x
pubmed: 15877669
Matteucci MC, Wühl E, Picca S et al (2006) Left ventricular geometry in children with mild to moderate chronic renal insufficiency. J Am Soc Nephrol 17:218–226. https://doi.org/10.1681/ASN.2005030276
doi: 10.1681/ASN.2005030276
pubmed: 16280471
Taddei S, Nami R, Bruno RM, Quatrini I, Nuti R (2011) Hypertension, left ventricular hypertrophy and chronic kidney disease. Heart Fail Rev 16:615–620. https://doi.org/10.1007/s10741-010-9197-z
doi: 10.1007/s10741-010-9197-z
pubmed: 21116711
Chavers BM, Herzog CA (2004) The spectrum of cardiovascular disease in children with predialysis chronic kidney disease. Adv Chronic Kidney Dis 11:319–327. https://doi.org/10.1053/j.arrt.2004.04.002
doi: 10.1053/j.arrt.2004.04.002
pubmed: 15241746
Mitsnefes MM, Kimball TR, Kartal J et al (2006) Progression of left ventricular hypertrophy in children with early chronic kidney disease: 2-Year follow-up study. J Pediatr 149:671–675. https://doi.org/10.1016/j.jpeds.2006.08.017
doi: 10.1016/j.jpeds.2006.08.017
pubmed: 17095341
Souza FL, Monteiro Junior FD, Salgado Filho N (2012) Effect of kidney transplantation on cardiac morphology and function. J Bras Nefrol 34:94–100
doi: 10.1590/S0101-28002012000100016
pubmed: 22441190
Jhinger MK, Sohal PM, Makkar V, Tondon R, Wander GS, Sandhu JS (2021) Changes in cardiac structure and function before and after renal transplantation: a longitudinal study. Transplant Proc 53:1014–1018. https://doi.org/10.1016/j.transproceed.2021.01.026
doi: 10.1016/j.transproceed.2021.01.026
pubmed: 33602526