ESPN 54th Annual Meeting

ESPN 2022


 
Cardiovascular assessment in a cohort of ADPKD children
LAURA LUCCHETTI 1 MARCELLO CHINALI 2 ALESSIO FRANCESCHINI 2 CAROLINA DANNA 2 FRANCESCO EMMA 1 LAURA MASSELLA 1

1- DEPARTMENT OF PEDIATRIC NEPHROLOGY, BAMBINO GESù CHILDRENS HOSPITAL, ROME, ITALY
2- DEPARTMENT OF PEDIATRIC CARDIOLOGY, BAMBINO GESù CHILDRENS HOSPITAL, ROME, ITALY
 
Introduction:

Cardiovascular events represent the first cause of morbidity and mortality in adults with autosomal dominant polycystic kidney disease (ADPKD). Hypertension occurs also in childhood, with a reported incidence ranging 15% to 44%. In 2008, M. Cadnapaphornchai et al reported increased, although not hypertrophic, left ventricular mass indexed to body surface (LVMI) in hypertensive ADPKD children. Our aim was to evaluate cardiac geometry and function in a cohort of ADPKD children.

Material and methods:

Patients with a confirmed diagnosis of ADPKD and a first echocardiogram performed before the age of 18 years were enrolled in the study.  Renal function, blood pressure, height and body weight were collected. Left ventricular hypertrophy (LVI) was defined as LV mass > 45g/(m2.16 + 0.09). 

Results:

Ninety-one patients (46M) were included in the study. The median age at the echocardiography was 11.5 years (1-23 years). Twenty-six (12M) patients started antihypertensive treatment at a median age of 10 years. All had well-controlled blood pressure at the time when echocardiography was performed. Two patients were hypertensive (treatment not yet started).  The median LVMI was 33 g ± 7.6 g. No difference was observed between patients treated or not treated for antihypertension (p= 0.771). Two patients had LVI; both were obese. No patient had systolic or diastolic dysfunction. No correlation was observed between LVMI and blood pressure. LVMI and GFR were inversely correlated (r=-0.54, p<0.01).

Conclusions:

All our children with ADPKD had normal LVMI and cardiac function, except two obese children. These data indicate that early blood pressure control can prevent median-term cardiovascular damage.