Left ventricular systolic dysfunction in pediatric chronic kidney disease patients

Background: Chronic kidney disease (CKD) affects multiple organs and is an established risk factor for cardiovascular disease and mortality. Impaired systolic function of the left ventricle is common in adult CKD patients. Objective: The main objective of the study is to determine the prevalence of left ventricular systolic dysfunction (LVSD) in children with CKD and its association with age, stage of disease, and history of dialysis. Subjects and Methods: This was a comparative cross-sectional descriptive study. Twenty-one children with CKD aged 3-14 years and an equal number of age- and gender-matched apparently healthy controls were recruited. Outcome Measures: LVSD was considered present when ejection fraction (EF) <50%. Results: The mean EF of 63.9% in the patients was not significantly lower than the 65.3% recorded in the controls, but LVSD was detected in 5 (24%) and none of the controls (Fisher's exact; P = 0.001). Patients with LVSD were older than those with normal left ventricular systolic function, but this difference was not statistically significant (P = 0.067); however, they differed significantly with respect to the stage of CKD (P < 0.001). LVSD was more common in patients who were never dialyzed (P < 0.001). Conclusion: LVSD is more frequent in children with CKD compared with controls. Patients with LVSD were similar to those without it, with respect to age but had more advanced disease (CKD) and less likely to have ever been dialyzed.