P45 Parameters for early detection of cardiovascular disease in maintenance dialysis pediatric patients

Introduction The excessive mortality seen in patients with end-stage renal disease (ESRD) is closely related to cardiac disease. We aimed to assess if there were distinctive parameters that can early predict cardiac disfunction in children on maintainance dialysis (MD). Methods From the ESRD database of our tertiary referral centre (2017–2018), we enrolled all patients on MD. For statistical analysis we used STATA software version 13. Results Twenty-four patients were on MD: mean age (± SD) 14.6 ± 4.7 years, mean duration of MD 3.5 years, 55% male. The study population was divided into two groups: group-1 consisted of patients with cardiomyopathy and group-2 included patients without cardiac disfunction. The two groups were similar regarding demographic characteristics, cardiovascular risk factors and uremia-related metabolic cardiac risk factors. On univariate analysis, a statistically significant difference was seen in the value of serum albumin (p=0.049) and s wave velocity on tissue doppler imaging (TDI) (p=0.02). No significant difference between the two groups was found for type of dialysis (hemodialysis or peritoneal dialysis), growth delay, laboratory parameters like homocisteine and NT-pro BNP (and a lot other), ECG parameters. Conclusions Some echocardiographic parameters such as systolic dysfunction assesed by s wave on TDI are the best tools for early diagnosis of cardiac disfunction. No ECG parameters were found to predict early disfunction. There are also bioumoral factors that can alert the clinician regarding cardiac malfunction such low level of seric albumin. Protocols for regular echocardiographic screening, diagnosis and monitoring of heart disease are recommended in the follow-up of these patients in order to provide a proper management of the disease and prevent complications like cardiac disease which is the main cause of morbidity and mortality in children with end-stage renal disease.