ESPN 51th Annual Meeting

ESPN 2018


 
Correlation of Cardiovascular Morbidity with elevated Serum Phosphate level in children with Advanced stage of Chronic Kidney Disease.
MD. HABIBUR RAHMAN 1

1- BANGABANDHU SHEIKH MUJIB MEDICAL UNIVERSITY, DHAKA, BANGLADESH
 
Introduction:

 This cross sectional analytical study was carried out to see the correlation of raised serum phosphate levels with CV morbidity in children with advanced stage of CKD.

Material and methods:

 This study  was carried  out in the department of Paediatric Nephrology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from January, 2017 to September,2017.Thirty children aged 1 to 18years diagnosed  as advanced stage of CKD ( eGFR <=30 ml/min/1.73m2), were enrolled in this study.Age and sex matched thirty healthy children  were enrolled as comparison group. Children with congenital heart disease and renovascular disease  were excluded from study.  Parameters for structural, systolic and diastolic function were assessed by-2D M-mode and  Doppler Echo. echocardiography .

Results:

 Out 30 patients mean age of study population was 11.76±5.25 years with male: female ratio was 1.5:1 and 71.01% (22Pt) had hypertension and 56.66%(17 pt) had heart failure. LVIDd, LVIDs, IVSd, IVSs, LVPWd and LVPWs had shown statistical significance (P value =0.001)but no statistical significance was observed inLVEF and FS in both the groups.  LVM (gm) in z score and LVM Index(g/m2)  were  respectively 2.8 ± 0.4 and  45 ± 5 64 and both values were significant in comparison to control group(P =0.03 and  <0.0001 respectively).

 

  Study patients had  low LV diastolic function(48.8% ;reversal E/A ratio)  and was significant in comparison to control group (P <0.001) .  Mean level of serum phosphate(IP) was  6.3 ± 1.4 mg/d. On Univariate analysis IP level was independently associated with the development of diastolic dysfunction (reversal E/A ratio ) (P <0.005) and LVMI inversely correlated with serum IP and it was also statistically significant (r = −0.53; P <0.05).On Multiple regression analysis LVMI, and E/A ratio were significantly associated with elevated serum phosphate (R2 = 0.605).

Conclusions:

Elevated serum  phosphate level was significantly associated with diastolic dysfunction .