PS 08-76 CONTROLLABLE FACTORS FOR A REDUCTION OF LEFT VENTRICULAR MASS IN PEDIATRIC PATIENTS WITH END STAGE RENAL DISEASE

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Abstract

Objective:

The aim of this study is to investigate a practically controllable factor for a reduction of increased left ventricular mass in children with end stage renal disease.

Design and Method:

Thirty five subjects dependent on peritoneal dialysis were enrolled. Clinical data were obtained through a review of medical records. Two serially followed echocardiographic data were obtained through off-line analysis. The averaged value of blood pressure and result of laboratory examinations which obtained from before 6 months to the day of echocardiography at each echocardiographic examinations, were adopted as data. The value of blood pressure and left ventricular mass index (LVMI) were indexed through a division of them by the reported 95 percentile value of normal pediatric population. The difference of laboratory and echocardiographic data between two data sets was additionally calculated.

Results:

The age of subjects was 12.9 ± 4.6 years at enrollment. Twelve (34%) among them were female. The predictive variables for left ventricular hypertrophy (LVH) were the starting age of peritoneal dialysis (OR 1.26, 95% CI 1.03–1.54, R = 0.023), indexed systolic blood pressure (OR 5978.93, 95% CI 4.16–8584490.46, P = 0.019), and left ventricular end diastolic dimension (OR 1.42, 95% CI 1.07–1.88, P = 0.014). The correlation analysis showed that the difference of indexed LVMI was significantly related to the difference of blood urea nitrogen levels (R = 0.421, P = 0.012) and the difference of the septal E/E’ (R = 0.447, P = 0.017).

Conclusions:

All of predictive variables of LVH would be not the practically controllable factors for a reduction of LVMI. Although the level of blood urea nitrogen was not predictive for LVH, its reduction was related to the reduction of indexed LVMI. This result implicates that a sufficient dialysis is also important in the management of patients with LVH. In addition, left ventricular diastolic function seems to be sensitively associated with LVMI.

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