The value of echocardiography for the assessment of the cardiac impairment in chronic renal failure in child.

UNLABELLED: Chronic renal failure (CRF) might gradually induce the occurrence of morphological and functional cardiac disturbances; these cardiac disturbances make up supplementary risk factors in children with CRF. The aim of our study was to determine the role of echocardiography(Echo) for the diagnosis of these cardiac disturbances acquired during the evolution of CRF in child. We studied 20 patients(aged between 5 and 18 years) with CRF, from whom 13 were dialysed. All patients underwent 2D echocardiography with Doppler, including the study of systolic and diastolic function of the left ventricle(LV). The main echocardiographic findings were:--concentric LV-hypertrophy(8 cases) and asymmetrical LV-hypertrophy(3);--dilated cardio-myopathy(3);--diastolic dysfunction of the LV(10);--normal systolic function in most of the cases;--mitral and tricuspid regurgitation(3);--pulmonary hypertension(2);--pericardial effusion (8) to cardiac tamponade (2). Echo allowed a better assessment of cardiac morphology and LV function and their improvement in some cases, after hemodialysis and antihypertensive therapy.

CONCLUSION: Echo exam has a great utility for the diagnosis of cardiac disturbances in children with CRF, especially in cases with severe cardiac involvement and without cardiac symptoms; this investigation has to be performed right since the initial diagnosis, as well as for long-term surveillance.