| Abstract [eng] |
Background. Increased mortality in chronic kidney disease patients is attributed to cardiovascular disease caused by vascular and cardiac injury. Concentric geometry is prevalent in children with chronic kidney disease. A likely cause is increased arterial stiffness in kidney disease. Methods. A cross-sectional analysis was performed using data from the 4C trial, done in 55 centers for pediatric nephrology across 12 European countries. The investigated association was that of pulse wave velocity (standardized for height, age, unstandardized) and left ventricle dimensions: relative wall thickness (standardized for age, unstandardized), mass index (separate standardizations), types of left ventricle geometry. Statistical tests included univariable and multivariable linear regressions, logistic regression, and stepwise regression. Results. 505 children aged 6-17 (stages 3a-5 of chronic kidney disease) were included in the analysis. The mean age was 12.1±3.3, 65% were boys, the dominant cause of chronic kidney disease were congenital anomalies of the kidneys and urinary tract (69.9%). Pulse wave velocity (standardized for height), relative wall thickness (standardized) (p=0.006) and respective unstandardized data (p=0.022) are significantly associated. The association between pulse wave velocity (standardized for height) and left ventricle mass index is statistically significant (p=0.001). Pulse wave velocity, concentric hypertrophy and concentric geometry were significantly associated (OR=1.318; CI[1.148; 1.520] and OR=1.163; CI[1.046; 1.297] respectively). Conclusions. Pulse wave velocity is associated with concentric left ventricle geometry. The association is of limited practicality. Pulse wave velocity standardization for height is preferred to standardization for age. Further longitudinal analyses of pulse wave velocity and left ventricle geometry are required. |
