Abstract

Background Patients with End-Stage Renal Disease (ESRD) on Peritoneal Dialysis (PD) experience high morbidity and mortality due to Cardiovascular (CV) disease. In pediatric patients, CV problems include Left Ventricular (LV) abnormalities, hypertension, and arrhythmias. The classic CV Risk Factors (RF) are not adequate to identify CV risk in these patients, but inflammation markers such as Ultrasensitive C-Reactive Protein (USCRP) may be useful in detecting early CV disease. The objective was to assess CV risk in pediatric patients with ESRD on PD and evaluate the utility of USCRP as a CV risk marker. Methods We included 12 patients aged 2 to 17 years. Measurements included blood pressure, biochemical profile, insulin resistance (HOMA index), blood count, lipid panel, parathyroid hormone, USCRP, echocardiogram, and carotid Doppler test. Results Average time on PD was 8 years. Two patients were overweight/obese. Eight patients had hypertension, and 4 had anemia. Eleven patients had abnormal lipid panel. Blood glucose levels were normal in all patients, but 5 had abnormal HOMA indices. Only one patient met criteria for metabolic syndrome. Ten patients had LV abnormalities, and 8 had increased carotid intimae-media thickness. USCRP was elevated in 7 patients. USCRP values were correlated with HOMA, dyslipidemia, and obesity. The capacity of USCRP to detect CV damage was good, for LV abnormality and increased carotid intimae-media thickness. Conclusions Significant CV damage was detected in this group. The classic RF was not always adequate to identify these CV abnormalities. However, USCRP could be superior to other RF in detecting the damage.

Authors and Affiliations