Aksu N, Yavascan O, Erdogan H, Dorak M C, Kansoy S, Kozan M
Department of Pediatric Nephrology, SSK Tepecik Teaching Hospital, Yenisehir, Izmir, Turkey.
Adv Perit Dial. 1998;14:255-7.
The aim of this study was to evaluate systolic and diastolic cardiac functions in children treated with continuous ambulatory peritoneal dialysis (CAPD). This study included a total of 21 patients (12 boys, 9 girls), aged 23 months to 14 years (average age: 10.1 +/- 4.32 years). The mean duration on CAPD was 12.88 +/- 6.69 months (range: 2-22 months). Twenty age- and sex-matched healthy subjects served as controls. Evaluation was made at the beginning of CAPD treatment in these 21 patients. Tests were repeated in 9 of 21 patients who had completed a 1-year follow-up period. We measured systolic functions [ejection fraction (EF), and fractional shortening (FS)], and diastolic functions [early (E) and late (A) diastolic peak inflow velocities, and E/A ratio, as well as early diastolic flow deceleration velocity (EF slope) and time (dt) functions] using two-dimensional, M-mode, color Doppler echocardiography. Interventricular septum thickness was also recorded. Blood pressure (BP) levels were monitored serially in all patients. Statistical evaluation was made using Student's t-test. Compared with control subjects, systolic and diastolic parameters were significantly inversely affected in patients on CAPD (P < 0.05). The mean BP levels did not differ significantly between CAPD patients and controls. In 9 patients with a second measurement on CAPD, systolic and diastolic cardiac functions tended to have deteriorated. However, these changes were not statistically significant (P > 0.05). In conclusion, CAPD is the preferable option in children with end-stage renal disease to maintain stable cardiac functions. However, systolic and diastolic dysfunctions tend to progress in children on CAPD.
本研究旨在评估接受持续性非卧床腹膜透析（CAPD）治疗的儿童的心脏收缩和舒张功能。本研究共纳入21例患者（12例男孩，9例女孩），年龄在23个月至14岁之间（平均年龄：10.1±4.32岁）。CAPD的平均治疗时长为12.88±6.69个月（范围：2 - 22个月）。选取20名年龄和性别匹配的健康受试者作为对照。对这21例患者在CAPD治疗开始时进行评估。在完成1年随访期的21例患者中的9例中重复进行测试。我们使用二维、M型、彩色多普勒超声心动图测量收缩功能[射血分数（EF）和缩短分数（FS）]以及舒张功能[舒张早期（E）和晚期（A）舒张期峰值流入速度、E/A比值，以及舒张早期血流减速速度（EF斜率）和时间（dt）函数]。还记录了室间隔厚度。对所有患者连续监测血压（BP）水平。采用Student's t检验进行统计学评估。与对照受试者相比，接受CAPD治疗的患者的收缩和舒张参数受到显著的反向影响（P < 0.05）。CAPD患者和对照者的平均BP水平无显著差异。在9例接受CAPD二次测量的患者中，心脏收缩和舒张功能有恶化趋势。然而，这些变化无统计学意义（P > 0.05）。总之，CAPD是终末期肾病儿童维持稳定心脏功能的首选方案。然而，接受CAPD治疗的儿童的收缩和舒张功能障碍有进展趋势。
