Chandigarh, India: Left ventricular dysfunction is significantly associated with the degree of anemia in children with chronic kidney disease (CKD), reveals a recent study. This implies that children with CKD and anemia should be screened for underlying cardiac dysfunction. And, suitable dietary modification and nutritional rehabilitation should be addressed for iron deficiency. The study appears in the journal Clinical Nutrition ESPEN.
In children with chronic kidney disease -- which results in significant morbidity and mortality -- myocardial l dysfunction is one of the common complications. Lesa Dawman, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India, and colleagues, therefore, aimed to find the impact of anemia with cardiac changes in children with CKD in a cross-sectional pilot study.
The study enrolled 54 children (38 males) up to the age of 16 years with different stages of CKD, not on dialysis. Cardiovascular functions were evaluated by an independent trained Pediatric Cardiologist using 2D-echocardiography. The M-mode measurements of the left ventricle were measured, indexed for body surface area and z-scores were calculated. The participants were divided into two groups i. e with (n=34) and without anemia (n=20).
Following were the study's salient findings:
The end-diastolic volume was significantly higher in patients with anemia when compared with those without anemia (46.43 ± 16.49 ml vs 32.51 ± 4.98 ml).
The mean left ventricular mass (59.54 ± 23.99 vs 37.24 ± 7.88 g) and end-diastolic thickness of the interventricular septum (0.73 ± 0.14 vs 0.54 ± 0.05 cm) was significantly elevated in CKD children with anemia.
"CKD children with anemia have a higher prevalence of cardiac dysfunction, particularly, left ventricular dysfunction. Depending on the degree of anemia, the hemodynamic changes may vary," the authors wrote.
"Considering the findings, it is suggested that CKD children with anemia should be screened for underlying cardiac dysfunction and appropriate dietary modification and nutritional rehabilitation for iron deficiency should be addressed," they concluded.
Reference:
"Impact of anemia on the cardiovascular status in children with chronic kidney disease: A pilot study," was published in the journal Clinical Nutrition ESPEN.
DOI: https://doi.org/10.1016/j.clnesp.2021.11.031