Assessment of Coronary Blood Flow in Children with Chronic Renal Failure on Regular Hemodialysis

Moustafa, Doaa; Sayed, Ilany; АІі, Al Shaymaa; Shehta, Faika

doi:10.21608/geget.2011.16892

Assessment of Coronary Blood Flow in Children with Chronic Renal Failure on Regular Hemodialysis

Document Type : Original Article

Authors

¹ Pediatric Nephrodialysis and Cardіology Units, Faculty of Medicine, Zagazig University, Eгqypt.

² Pediatric Nephrodialysis and Cardіology Units, Faculty of Medicine, Zagazig University, Eгqypt

10.21608/geget.2011.16892

Abstract

Background: Coronary flow reserve (CFR) reflects the functional capacity of the microcirculation to adapt to blood demand during increased cardiac work. Diminished CFR may account for several symptoms that are often encountered in haemodialysis patients such as chest pain, arrhythmia and hypotension. lschemic heart disease is by far the leading cause of morbidity and mortality in haemodialysis (HD) patients. Sіnce prevention is not easy, early detection of the disease is the key issue.
Objectives: Assessment of coronary flow reserve in children with chronic renal failure on regular hemodialy-sis with transthoracic Doppler echocardiography using dipyridamole as and inducer of coronary hyperemia. Methods: Sixty children of matching age and sex were included in this study, 20 healthy children as a control group and 40 children with chronic renal failure on regular haemodialysis. All studied children were subjected complete history taking, thorough clinical examination, laboratory investigations and assessment of coronary flow reserve with transthoracic Doppler echocardiography using dipyridamole as inducer of coronary hyperemia.
Results: There was a significant negative correlation between CFR and LVMI, duration of dialysis, serum cholesterol, triglycerides, LDL levels and blood pressure in hemodialysis patients. A significant positive correlation between CFR and serum IIDI. level was found. There was no significant correlation between CFR and different laboratory parameters.
Conclusion: CFR is significantly reduced in children with CAF on regular hemodialysis. Control of blood pressure, correction of anemia and hypervolemia, diet management and physical activity are important in the prevention of / decrease in or improving the coronary flow reserve (CFR).

Keywords