[Multifactorial analysis of the cardiocirculatory compromise in children with chronic renal insufficiency in hemodialysis. An echocardiographic study].

M-mode echocardiographic assessment of cardiovascular state and function was performed in 15 children (mean age 10.8 +/- 3.36 years) with chronic renal failure (CRF) on regular chronic hemodialysis. The echocardiograms were recorded just before the routine dialytic session and usual echocardiographic measurements of cardiac sections were analyzed according to the standard criteria. Subsequently, shortening fraction (SF) of the left ventricle (LV), ratio LVPEP/LVET (LV preejection period/ejection period) and LV mass were calculated. All the echocardiographic measured and derived parameters were therefore compared by means of multiple regression analysis with the following factors potentially influencing cardiac performance in CRF: age, duration of CRF, time on dialysis, presence of hypertension, mean arterial pressure, degree of anemia (Hct) and degree of uremia (blood urea). Left ventricular concentric hypertrophy, significantly correlated with the presence and severity of hypertension (p less than 0.001) was found in 80% of cases; LV dilatation was present in 46.67%. The LV function was not significantly impaired on the whole: mean values for group of the SF and of the ratio LVPEP/LVET were normal; four patients (26.7%) showed a slight decrease of the SF and two other cases had an abnormal LVPEP/LVET ratio. These abnormalities cannot be clearly attributed to a specific myocardial impairment and reflect probably the changes in preload and afterload secondary to volume and pressure variations. None of the other analyzed factors (duration of CRF, time on dialysis, Hct, blood urea) showed a significant correlation with the echocardiographic parameters.(ABSTRACT TRUNCATED AT 250 WORDS)