Abstract: FR-PO0735
Left Ventricular Strain in Children with CKD: Systematic Review and Meta-Analysis
Session Information
- Pediatric Nephrology: CKD, ESKD, and Glomerular Diseases
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1900 Pediatric Nephrology
Authors
- Castro, Paulo de Coelho, Universidade de Sao Paulo, São Paulo, SP, Brazil
- Huntermann, Ramon, Centro Universitario para o Desenvolvimento do Alto Vale do Itajai, Rio do Sul, SC, Brazil
- Erzinger, Gabriel, Universidade da Regiao de Joinville Departamento de Medicina, Palhoça, SC, Brazil
- Estrela de Araújo, Luís Henrique, Faculdade de Ciencias Medicas da Paraiba, João Pessoa, PB, Brazil
- Gonçalves, Lívian Sousa, Universidade Nove de Julho Curso de Medicina, São Paulo, SP, Brazil
- Luiz, Laura, Universidade da Regiao de Joinville Departamento de Medicina, Palhoça, SC, Brazil
- Karlinski Vizentin, Vanessa, Mayo Foundation for Medical Education and Research, Rochester, Minnesota, United States
- Carrera, Caroline Feu Rosa, Universidade de Sao Paulo, São Paulo, SP, Brazil
Background
Chronic kidney disease (CKD) in children is associated with increased risk of cardiovascular disease. In adults with CKD, impaired left ventricular global longitudinal strain (LV GLS) is established as an early marker of ventricular dysfunction, demonstrating superior prognostic value than conventional measures. However, data on LV GLS in pediatric CKD patients remain inconsistent.
Methods
We conducted the first, to our knowledge, systematic review and meta-analysis evaluating speckle-tracking echocardiographic (STE) parameters in children with CKD. The study was registered in PROSPERO (CRD42024617262). A comprehensive search of PubMed, Embase, and Cochrane Central databases identified studies assessing LV GLS using STE in patients under 18 years.
Results
A total of 23 observational studies comprising 1,965 pediatric CKD patients across all CKD stages were included. The pooled mean LV GLS was -18.14% (95% CI: -17.34 to -18.93; I2 = 98.9%), the mean left ventricular ejection fraction (LVEF) was 62.25% (95% CI: 59.76 to 64.75; I2 = 95.9%), and the mean E/e’ ratio was 6.62 (95% CI: 5.95 to 7.29; I2 = 98.9%). Compared to controls, children with CKD demonstrated significantly reduced myocardial strain (LV GLS mean difference [MD]: 2.26%; 95% CI: 1.07 to 3.44; I2 = 90.9%), lower LVEF (MD: -2.68%; 95% CI: -4.11 to -1.26; I2 = 84.3%), and an elevated E/e’ ratio (MD: 0.67; 95% CI: 0.02 to 1.33; I2 = 86.2%; p = 0.04).
Conclusion
Children with CKD exhibit impaired myocardial strain and ventricular dysfunction, as evidenced by STE-derived LV GLS and conventional echocardiographic parameters. Further longitudinal studies are needed to evaluate the prognostic implications of reduced LV GLS.