Blood pressure and echocardiographic measurement of left ventricular mass in children with nephrotic syndrome

ABSTRACT

Blood pressure and left ventricular mass index were studied in nephrotic children. The study included 40 nephrotic patients [17 were recently diagnosed, 12 with frequent relapse and 11 with persistent proteinuria]. They were recruited from multiple pediatric nephrology clinics. The study also included 17 healthy children of comparable and sex as a control group. For each child; a medical history, complete clinical examination measurements of weight, height, body surface area and blood pressure were done. Besides, routine urinalysis, proteinuria/24 hours, total plasma proteins and albumin, serum cholesterol, blood urea and creatinine were subjected to electrocardiographic detection of left ventricular hypertrophy and echocardiographic measurements of left ventricular mass. High blood pressure was found in 21.4% of recently diagnosed cases prior to initiation of corticosteroid therapy. The percentage was higher among children with frequent relapses [72.4%] and those with persistent proteinuria [100%]. The study found a significant increase in the mean values of weight, body surface area, LVEDD, PWT, IVS, LVM, LVMI and blood pressure between different groups of cases and controls. A significant correlation was observed between LVMI and age, blood pressure and duration of the disease. Multiple regression analysis in cases to predict LVMI showed that duration of the disease is the most important factor. The results showed that echocardiographically measured LVMI is an important early predictor of left ventricular hypotrophy and creating a cut off value based on the 98th percentile of LVMI among children is needed