Becker-Cohen Rachel, Nir Amiram, Ben-Shalom Efrat, Rinat Choni, Feinstein Sofia, Farber Benjamin, Frishberg Yaacov
Division of Pediatric Nephrology, Shaare Zedek Medical Center, P.O. Box 3235, Jerusalem, Israel, 91031.
Pediatr Nephrol. 2008 Sep;23(9):1545-50. doi: 10.1007/s00467-008-0855-5. Epub 2008 Jun 12.
Left ventricular hypertrophy (LVH) is a risk factor for cardiovascular disease, and it is prevalent in children with end-stage renal disease (ESRD) and after renal transplantation (RTx) on cross-sectional studies. Our aim was to compare prospectively left ventricular mass index (LVMI) in children with ESRD, before and after RTx. Thirteen patients aged 1.5-15 years underwent echocardiogram prior to and at least 3 months after RTx, and again in the second year after transplantation. A control group consisted of children with ESRD who remained on dialysis. Systolic and diastolic blood pressure index decreased significantly over the study period only in the children who had undergone RTx. Mean LVMI in children with ESRD decreased from 45.4 +/- 12.6 g/m(2.7) to 34.9 +/- 10.4 g/m(2.7) after RTx (P = 0.001), but it remained unchanged in patients who remained on dialysis. The prevalence of LVH decreased from 54% to 8% (P = 0.03) after RTx. Systolic and diastolic blood pressure index were correlated with LVMI. Mean body mass index increased during the study period from 17.3 +/- 2.5 to 20 +/- 4.6 (P = 0.05); however, no correlation was found with LVMI. LVH in children with ESRD is potentially reversible after RTx, especially with good control of hypertension.
左心室肥厚(LVH)是心血管疾病的一个危险因素,在横断面研究中,其在终末期肾病(ESRD)儿童及肾移植(RTx)后儿童中普遍存在。我们的目的是前瞻性比较ESRD儿童肾移植前后的左心室质量指数(LVMI)。13例年龄在1.5至15岁的患者在肾移植前、肾移植后至少3个月以及移植后第二年接受了超声心动图检查。一个对照组由仍在接受透析的ESRD儿童组成。仅在接受肾移植的儿童中,收缩压和舒张压指数在研究期间显著下降。ESRD儿童的平均LVMI在肾移植后从45.4±12.6 g/m(2.7)降至34.9±10.4 g/m(2.7)(P = 0.001),但仍在接受透析的患者中该指数保持不变。肾移植后LVH的患病率从54%降至8%(P = 0.03)。收缩压和舒张压指数与LVMI相关。研究期间平均体重指数从17.3±2.5增至20±4.6(P = 0.05);然而,未发现其与LVMI相关。ESRD儿童的LVH在肾移植后可能是可逆的,尤其是在高血压得到良好控制的情况下。