Predictors of left ventricular hypertrophy in children on chronic peritoneal dialysis |
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Authors: | Zelal Bircan Ali Duzova Nilgun Cakar Aysun Karabay Bayazit Atilla Elhan Ercan Tutar Z. Birsin Ozcakar Tayfun Ucar Evrim Kargın Sevcan Erdem Tevfik Karagöz Abdulkadir Babaoglu Banu Sancak Aytul Noyan Oguz Soylemezoglu Aysin Bakkaloglu Fatos Yalcinkaya |
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Affiliation: | 1. Pediatric Nephrology, Kocaeli University School of Medicine, Kocaeli, Turkey 2. Pediatric Nephrology and Rheumatology, Hacettepe University School of Medicine, Ankara, Turkey 3. Pediatric Nephrology, Ministry of Health Diskapi Children’s Hospital, Ankara, Turkey 4. Pediatric Nephrology, Cukurova University School of Medicine, Adana, Turkey 5. Biostatistics, Ankara University School of Medicine, Ankara, Turkey 6. Pediatric Cardiology, Ankara University School of Medicine, Ankara, Turkey 7. Pediatric Nephrology, Ankara University School of Medicine, Ankara, Turkey 8. Pediatrics, Ministry of Health Diskapi Children’s Hospital, Ankara, Turkey 9. Pediatric Cardiology, Cukurova University School of Medicine, Adana, Turkey 10. Pediatric Cardiology, Hacettepe University School of Medicine, Ankara, Turkey 11. Pediatric Cardiology, Kocaeli University School of Medicine, Kocaeli, Turkey 12. Medical Biochemistry, Gazi University Faculty of Medicine, Ankara, Turkey 13. Pediatric Nephrology, Gazi University Faculty of Medicine, Ankara, Turkey 14. Pediatric Nephrology, Ankara University School of Medicine, Ankara, 06500, Turkey
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Abstract: | Conflicting results have been reported in small non-homogenous groups of children with chronic renal failure in terms of casual blood pressure and ambulatory blood pressure monitoring (ABPM) parameters and left ventricular hypertrophy (LVH). The aim of our study was to assess the value of ABPM and hematological and biochemical parameters in predicting LVH in children on chronic peritoneal dialysis (CPD). Echocardiography and 24-h ABPM were performed in addition to routine biochemical and hematological evaluations in 47 children on CPD (26 male, 21 female; mean age 14.74?±?3.52 years). Mean daytime systolic blood pressure (SBP) and mean daytime diastolic blood pressure (DBP) values were found to be higher than the mean casual SBP and DBP (p?=?0.001) values. Thirty-three (70.2%) children had LVH. The correlations between the left ventricular mass index and ABPM variables were good. Stepwise multiple regression analysis revealed daytime SBP load (β?=?0.652; p?0.01) and hematocrit (β?=??0.282; p?0.01) to be independent predictors of LVH. The sensitivity, specificity, positive predictive value, and negative predictive values for the combination of the SBP load >15% and hematocrit value <31% for predicting LVH were 95 [95% confidence interval (CI) 76–99], 78 (95%CI 45–94), 91 (95%CI 73–98), and 88% (95%CI 69–96%), respectively. We conclude that: (1) LVH is prevalent in children on CPD, and (2) a target hematocrit level >31% and daytime SBP load <15% may be preventive for the progression of LVH in the follow-up of children on CPD. |
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