Pediatric CKD with Anemia Impacts CV Status

One of the most common complications of pediatric chronic kidney disease (CKD) is myocardial dysfunction, resulting in significant morbidity and mortality. Naveen Bhagat, MD, and colleagues conducted a cross-sectional pilot study designed to determine the impact of anemia with cardiac changes in children with CKD. Results were reported in Clinical Nutrition ESPEN [2022;47:283-287].

A total of 54 children <16 years of age with varying stages of non-dialysis-dependent CKD were enrolled. An independent pediatric cardiologist used 2D-echocardiography with a EPIC-7 (Philips) machine to evaluate cardiovascular functions. The M-mode measurement of the left ventricle was measured, indexed for body surface area, and z-scores were evaluated. Patients were divided into two groups: one group with anemia and one group without anemia.

Of the 54 children, 34 had anemia and 20 did not have anemia. The end-diastolic volume was significantly higher in patients with anemia compared with those without anemia (46.43 vs 32.51 ml). The left ventricular mass and end-diastolic thickness of the interventricular septum were also significantly elevated in the children with CKD and anemia (59.54 vs 37.24 g and 0.83 vs 0.54 cm, respectively).

In summary, the authors said, “Left ventricular hypertrophy along with ventricular dimension and left ventricular diastolic dysfunction was found to be significantly correlating with the degree of anemia. CKD children with anemia should be screened for underlying cardiac dysfunction and appropriate dietary modification and nutritional rehabilitation for iron deficiency should be addressed.”