The impact of bone mineral biomarkers on diastolic cardiac function in children and adolescents on regular hemodialysis

Abstract

Background: Chronic kidney disease (CKD) affects adults and children globally and is a critical health concern. Cardiovascular disease (CVD) was identified over ten years ago as a leading cause of death in children with advanced CKD. Numerous studies that evaluate cardiovascular risk, disease processes, and early markers of CVD in cases with CKD have been published as a result of this observation. Children with CKD have an exceptionally high prevalence of conventional and uremia-related CVD predisposing factors, much like adults do.
Objective: The aim was to study the impact of bone markers and other laboratory tests on diastolic cardiac functions in children and adolescent with CKD on regular hemodialysis.
Patients and Methods: A cross-sectional observational study was conducted on 40 patients with CKD on regular hemodialysis, from May 2022 to June 2023 in the Pediatric Nephrology and Cardiology Department at Sohag University Hospital.
Results: The commonest causes of CKD were congenital anomalies of the kidney and urinary tract (CAKUT) in 77.5% of patients. The mean age of patients was 14.18 ± 4.36 years. Evaluation of cardiac function showed that 57.5% of cases had diastolic dysfunction and 70% of cases had left ventricular hypertrophy (LVH). There was a statistically significant correlation between diastolic dysfunction with anemia and hyperparathyroidism (p<0.05). Hypertension was significantly accompanied by LVH (p=0.045).
Conclusion: Our study revealed that the most important factors affecting all parameters of diastolic function were anemia and hyperparathyroidism. Other factors affecting the diastolic function to a lesser extent were hypertension and residual kidney function (RKF). There was a substantial correlation between LVH and hypertension.