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Abstract: TH-PO0312

Left Atrial Strain in the CKD in Children (CKiD) Study

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical

Authors

  • Kula, Alexander J., Stanley Manne Children's Research Institute, Chicago, Illinois, United States
  • Mitsnefes, Mark, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  • Warady, Bradley A., Children's Mercy Kansas City, Kansas City, Missouri, United States
  • Furth, Susan L., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Cai, Xuan, Northwestern University Department of Medicine, Chicago, Illinois, United States
Background

Diastolic dysfunction (LVDD) is a precursor of heart failure. Measures used to identify LVDD on echocardiogram, such as E/e’, are inaccurate in youth with CKD. In adult CKD, Left atrial strain (LAS) is a sensitive marker of LVDD and is associated with risk for cardiovascular disease. Studies measuring LAS in youth with CKD are needed given the potential for LAS to advance detection of LVDD in this high-risk population. The objective of this study was to measure LAS in the Chronic Kidney Disease in Children (CKiD) study and investigate clinical determinants of LAS.

Methods

We reanalyzed echocardiograms collected as part of CKiD to measure LAS. CKiD included youth aged 1-18 years with an eGFR of 30-90 and exluded those with a kidney transplant, dialysis, or structural heart disease. Measurement of causal blood pressure (BP) and labs were protocolized. To test the association between variables with LAS, we used a set of generalized estimating equations to account for within-person correlation.

Results

LAS data was measurable for n=936 person-visits. Mean LAS was 38.6±12.1. The cohort had a mean age of 13±5yrs, 36% were female, mean eGFR was 47±20, 20% had a glomerular etiology of their CKD, and 18% were hypertensive. The association between clinical variables and LAS are described in Table 1.

Conclusion

LAS in youth with CKD was lower than in studies of healthy children. The association between proteinuria and left-atrial dysfunction has been noted in studies of adults with diabetes, heart failure, and CKD. Our results support ongoing studies into LAS in pediatric CKD.

Line indicates lower 5% of LAS in recent pediatric meta analysis

Funding

  • NIDDK Support

Digital Object Identifier (DOI)