Cardiovascular disease in pediatric chronic dialysis patients

Blanche M. Chavers, Shuling Li, Allan J. Collins, Charles A. Herzog

Research output: Contribution to journalArticle

153 Scopus citations

Abstract

Background. Little information is available regarding cardiac morbidity and mortality in children with end-stage renal disease. We sought to determine the incidence of cardiac morbidity and mortality in pediatric chronic dialysis patients. Methods. Medicare incident pediatric (0 to 19 years) dialysis patients from 1991 to 1996 were identified from the United States Renal Data System. Study endpoints included development of arrhythmia, valvular heart disease, cardiomyopathy, or cardiac arrest, all causes of death, and cardiac-related death. Statistical analyses were performed using the Poisson regression model and chi-square test. Results. A total of 1454 children were eligible for inclusion, 452 (31.1%) of whom developed a cardiac-related event. Arrhythmia was the most common event (19.6%) compared with valvular disease (11.7%), cardiomyopathy (9.6%), and cardiac arrest (3%). Arrhythmia and valvular heart disease incidence were increased in 15- to 19-year-olds (P < 0.0001 for both), females (P = 0.004, P = 0.03) and blacks (P = 0.0001, P = 0.002). Cardiomyopathy incidence was increased in blacks (P = 0.001) and tended to be increased in females (P = 0.053). The adjusted annual cardiomyopathy rate during the first 3 years increased between 1991 and 1996 (P = 0.003). Death occurred in 107 patients, and 41 (38%) were cardiac deaths. Conclusions. Cardiovascular disease is a significant cause of morbidity and mortality in pediatric chronic dialysis patients. Cardiomyopathy incidence is increasing. Black, female, and adolescent children have increased risk for cardiovascular disease.

Original languageEnglish (US)
Pages (from-to)648-653
Number of pages6
JournalKidney international
Volume62
Issue number2
DOIs
StatePublished - Aug 2002

Keywords

  • Adolescents and HD
  • Cardiovascular disease
  • Children
  • Dialysis
  • End-stage renal disease
  • Heart

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