Indicators of Vascular Dysfunctions in Children with End Stage Renal Disease under Regular Haemodialysis as Paediatric Emergency

Background: There is a necessity to predict cardiovascular diseases in children with end stage renal disease (ESRD) on regular haemodialysis. Objectives: to study biochemical, structural and functional indicators of vascular dysfunction in children with ESRD on regular haemodialysis (HD) and their correlations as early predictors of cardiovascular diseases in dialysis children. Materials and methods: The present study was carried out on 30 children with ESRD on regular hemodialysis in Tanta University hospital and 30 healthy age and sex matched children as controls. All patients and control were subjected to history taking, clinical examination including, routine laboratory assessment measuring serum cholesterol, serum calcium and phosphorous, Ca × P product, serum alkaline phosphatase and serum intact parathyroid hormone (iPTH). Radiological assessment was done using B-mode ultras-onography to assess arterial calcifications, arterial stiffening by measuring mean CCA diameter in mm, carotid intima media thickness (CCA-IMT in μm), aortic PWV in cm/sec, Renal Resistance Index. Results: Twelve (80%) of the studied patients showed calcifications in one or more of the studied different sites. There was a highly significant increase in the CCA diameter, CCA-IMT and Ao. PWV in studied patients as compared to the controls but there was no significant difference between patients and controls as regard renal RI (P>0.05). Conclusion: Vascular calcifications in children with ESRD on regular haemodialysis are associated with increased stiffness of large, arteries. The extent of arterial calcification increases mainly with the duration of dialysis and abnormalities in Ca × P product