Left Ventricular Function and Geometry of Children with Chronic Kidney Disease (CKD) in a Resource-Poor Setting of Africa.

BACKGROUND

Chronic Kidney Disease (CKD) is a multisystemic clinical condition characterized by an irreversible deterioration of renal function that invariably progresses to end-stage renal disease (ESRD). Cardiovascular affectation portends morbidity and mortality in chronic kidney disease.

OBJECTIVE

The aim of the study was to compare the prevalence of changes in function, and geometry of the left ventricle in children with CKD and their controls.

METHODOLOGY: This was a descriptive cross-sectional study. Children aged 6 to 17 years with features suggestive of CKD along with age and sex-matched apparently healthy controls seen at the University of Nigeria Teaching Hospital, Enugu were enrolled consecutively. Blood samples werecollected for baseline investigations and e-GFR, followed by trans-thoracic two-dimensional echocardiography to assess the left ventricular function and geometry. Data was analysed using the statistical package for social sciences (SPSS) version 17.0. Simple frequencies and proportions, Student's t-test and chi-square were applied appropriately. P value at <0.05 was significant.

RESULTS

Out of 9,419 children aged 6-17 years seen within the study period in the hospital, 24 met the criteria for CKD. The incidence rate was 5 cases per million child population per year. Mean age was 12.33 ± 4.24 years, with a male to female ratio of 2:1. Left ventricular hypertrophy (LVH), eccentric LVH and Left ventricular dilatation (LVD) were seen in 50.0%, 33.3% and 41.7% of subjects respectively. Left ventricular diastolic dysfunction and left ventricular systolic dysfunction occurred in 37.5% and 8.3% subjects, respectively.

CONCLUSION

Prevalence of left ventricular geometry and function abnormalities was high in subjects. Intervention measures are advocated.