Left ventricular geometry in children with chronic renal failure.

The aim of the study was to assess left ventricular (LV) geometry in children with chronic renal insufficiency (CRI), and its relationship with glomerular filtration rate (GFR) and preexisting renal disease. Echocardiography was performed on 56 non-dialysed CRI patients and 56 controls. CRI patients had bigger interventricular septum thickness (0.77+/-0.17 vs. 0.67+/-0.12 cm, p=0.002), LV posterior wall thickness (0.79+/-0.14 vs. 0.71+/-0.14 cm, p<0.006), LV mass index (LVMI) (40.7+/-12.2 vs. 31.7+/-6.3 g/m2.7, p<0.0001; 86.4+/-24.1 vs. 69.1+/-13.9 g/m2, p<0.0001), and relative wall thickness (0.38+/-0.05 vs. 0.34+/-0.04, p<0.0001) in comparison with controls. Twenty (36%) of CRI patients had LV hypertrophy (LVH). Thirteen patients (23%) had eccentric LVH, 7 (13%)-concentric LVH), and 9 (16%) of patients-concentric LV remodeling. No significant difference was found between LV parameters in patient groups with different GFR. Patients with acquired renal diseases and hereditary nephropathies had significantly higher LVMI than patients with congenital renal abnormalities. Our results indicate that changes of LV geometry are present in children with mild, moderate and predialysis CRI. These findings support the concept of cardiovascular disease risk for patients with different stages of CRI.