Severe cardiac hypertrophy and long-term dialysis: the Midwest Pediatric Nephrolgy Consortium study

Cross-sectional studies have demonstrated that left ventricular hypertrophy (LVH) is common in children on maintenance dialysis. We report the echocardiogram results of 17 children from seven centers in the Midwest Pediatric Nephrology Consortium who have spent at least 2 years on maintenance dialysis and had three consecutive echocardiograms: at initiation of dialysis therapy and 1 and 2 years later. The results indicate that LVH is prevalent at the initiation of dialysis (82%) and remains both frequent (82%) and severe (59%) after 2 years of maintenance dialysis. Normalization of LV geometry was unlikely: the prevalence of concentric LVH increased and the prevalence of eccentric LVH did not change over time, indicating poor blood pressure and volume status control in these patients. We conclude that children on maintenance dialysis are at high risk for future cardiovascular disease.