Kidney Week

Abstract: FR-PO0736

Left Ventricular Remodeling by Cardiac Magnetic Resonance in Children with Advanced CKD: Analysis of the CKD in Children (CKiD) Study

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

• Reyes, Loretta, Emory University, Atlanta, Georgia, United States

Loretta Reyes, MD

• Roem, Jennifer, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States

Jennifer Roem, MS

• Warady, Bradley A., Children's Mercy Kansas City, Kansas City, Missouri, United States

Bradley A. Warady, MD

• Furth, Susan L., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States

Susan L. Furth, MD, PhD

• Mitsnefes, Mark, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

Mark Mitsnefes, MD, MS

Group or Team Name

• For the CKiD Study Investigators.

Background

Children with advanced chronic kidney disease (CKD) have a high burden of cardiovascular disease (CVD). Left ventricular hypertrophy (LVH) and abnormal myocardial strain are prevalent in patients with CKD and confer increased risk for morbidity and mortality. While echocardiography is conventionally used to assess myocardial function, cardiovascular magnetic resonance imaging (CMR) provides superior assessment of myocardial morphology and function compared to echocardiography. We aimed to assess the CMR features of children enrolled in the Chronic Kidney Disease in Children (CKID) study with advanced CKD and to evaluate the relationship between CKD and CVD severity.

Methods

A subset of CKiD patients with eGFR < 30 ml/min/1.73m² underwent CMR. Left ventricular mass indexed to body surface area (LV mass index), global peak longitudinal strain (GLS) and global peak circumferential strain (GCS) were the primary continuous outcomes measured by CMR. We quantified associations between clinical and demographic risk factors with LV mass index, GLS and GCS using linear regression and utilized a variant of stepwise regression to identify combinations of independent variables that were most associated with the primary outcomes.

Results

We analyzed 47 CKiD participants with a median age of 16 years and median eGFR of 25 ml/min|1.73m². LVH was prevalent at 13% and abnormal GLS and GCS (>95^th %ile of normative values) were prevalent at 60% and 68%, respectively. Six percent of participants had a clinically significant abnormally low absolute GLS (<15). Worse GLS and GCS were independently associated with higher LV mass index.

Conclusion

Abnormal myocardial strain (>95^th %ile of normative values) on CMR was highly prevalent and related to higher LV mass index in the CKiD cohort with advanced CKD.

Funding

• NIDDK Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025peh9njm2