DIASTOLIC FUNCTION IN CHILDREN AND ADOLESCENTS ON DIALYSIS AND AFTER KIDNEY-TRANSPLANTATION - AN ECHOCARDIOGRAPHIC ASSESSMENT

Thirty-seven children and adolescents on renal replacement therapy (11 on haemodialysis, 14 on continuous ambulatory peritoneal dialysis and 12 after renal transplantation) were studied by echocardiography, ech o-Doppler and phonocardiography. Right and left ventricular (R/L V) di astolic functions were measured by transmitral and transtricuspid flow velocities and by LV isovolumic relaxation time (LVIRT). Thirty-seven age- and sex-matched healthy subjects served as controls. R/L V diast olic dysfunction was only observed in the dialysis patients. In these patients LVIRT was prolonged. LV and RV peak inflow velocities were in creased both in early (E) and late (A) diastole with a reduction in th e E/A ratios. This pattern of diastolic dysfunction is compatible with the combined effects of a hypercirculatory state (volume overload, an aemia, arteriovenous fistula) and an abnormality of cardiac relaxation . The transplant patients showed no major cardiac abnormalities.