Disfungsi Jantung Subklinis pada Anak yang Menjalani Hemodialisis

Anisa Rahmadhany, Henny Adriani Puspitasari, Kamilia Rifani Ufairah

Sari


Latar belakang. Mortalitas anak dengan penyakit ginjal kronik paling sering disebabkan oleh komplikasi kardiovaskular yang dapat terjadi sejak stadium awal penyakit. Pada anak yang menjalani hemodialisis, banyak faktor untuk terjadinya disfungsi kardiovaskular, seperti kadar hemoglobin, laju ultrafiltrasi yang tinggi dan derajat kelebihan cairan. Teknik ekokardiografi dua dimensi dengan speckle tracking echocardiography merupakan metode yang sensitif untuk menilai penurunan fungsi jantung pada stadium awal. Di Indonesia, saat ini penelitian metode tersebut belum banyak dilakukan pada anak dengan penyakit ginjal kronik yang menjalani hemodialisis.
Tujuan. Untuk mengetahui sensitivitas dan spesifisitas speckle-tracking echocardiography dalam mendeteksi disfungsi jantung subklinis pada anak dengan penyakit ginjal kronik yang menjalani hemodialisis.
Metode. Penelitian potong lintang dilakukan terhadap 33 pasien hemodialisis anak di Unit Dialisis Pediatrik Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, Jakarta. Data demografis dan klinis diperoleh dari rekam medik elektronik. Penilaian dan interpretasi ekokradiografi dilakukan oleh dokter kardiologi anak.
Hasil. Hampir sebagian besar subyek memiliki disfungsi jantung subklinis dengan pemeriksaan global longitudinal strain speckle-tracking echocardiography. Sensitivitas dan spesifisitas sebesar 90% dan 70%.
Kesimpulan. Pemeriksaan global longitudinal strain speckle-tracking echocardiography memiliki sensitivitas yang baik dalam mendeteksi disfungsi jantung subklinis pada anak yang menjalani hemodialisis.


Kata Kunci


hemodialisis; kardiovaskular; komplikasi; STE; echocardiography

Teks Lengkap:

PDF

Referensi


Massengill SF, Ferris M. Chronic kidney disease in children and adolescents. Pediatr Rev 2014;35:16-29.

Ardissino G, Dacco V, Testa S, Bonaudo R, Claris-Appiani A, Taioli E, dkk. Epidemiology of chronic renal failure in children : Data from the ItalKid project. Pediatrics 2003;111:e382-7.

Mitsnefes MM. Cardiovascular disease in children with chronic kidney disease. J Am Soc Nephrol 2012;23:578-85. doi.org/10.1681/ASN.2011111115.

Chen W ling, Tain Y lin, Chen H en, Hsu C ning. Cardiovascular disease risk in children with chronic kidney disease : impact of apolipoprotein. Front Pediatr 2021;9:1-11.

Collins AJ, Foley RN, Chavers B, Gilbertson D. US Renal data system 2011 annual data report. Vol. 59. 2012. doi.org/10.1053/j.ajkd.2011.11.015.

Saland JM, Pierce CB, Mitsnefes MM, Joseph T, Goebel J, Kupferman JC, dkk. Dyslipidemia in children with chronic kidney disease: A report of the chronic kidney disease in children (CKiD) study. Kidney Int 2010;78:1154-63.

Wilson AC, Schneider MF, Cox C, Greenbaum LA, Saland J, White CT. Prevalence and correlates of multiple cardiovascular risk factors in children with chronic kidney disease. Clin J Am Soc Nephrol 2011;6:2759-65.

Shroff R. Reducing the burden of cardiovascular disease in children with chronic kidney disease : prevention vs damage limitation. Pediatr Nephrol 2021;36:2537-44.

Glassock RJ, Pecoits-filho R, Barberato SH. Left ventricular mass in chronic kidney disease and ESRD. Clin J Am Soc Nephrol 2009;4:79-91.

Ahmad SEA, Ali AB, Abdallah Z. Left ventricular mass index as a prognostic factor in children with chronic kidney disease. J Curr Med Res Pr 2019;4:34-7.

Doyon A, Haas P, Erdem S, Ranchin B. Impaired systolic and diastolic left ventricular function in children with chronic kidney disease - results from the 4C study. Sci Rep 2019;9:11462.

Peter ID, Aliyu I, Asani MO, Obiagwu PN, Ige OO, Thomas FB. Left ventricular systolic dysfunction in pediatric chronic kidney disease patients. Res Cardiovasc Med 2019;12:79-83.

Tissot C, Singh Y, Sekarski N, Sekarski N. Echocardiographic evaluation of ventricular function—for the neonatologist and pediatric intensivist. Front Pediatr 2018;6:1-12.

Eidem BW, Mcmahon CJ, Cohen RR, Wu J, Finkelshteyn I, Kovalchin JP, dkk. Impact of cardiac growth on doppler tissue imaging velocities: a study in healthy children. J Am Soc Echocardiogr 2003;17:212-21.

Tafreshi RI, Human N, Otukesh H, Nikavar A. Evaluation of combined left ventricular function using the myocardial performance index in children with chronic kidney disease. Echocardiography 2011;28:97-103.

Levy PT, Machefsky A, Sanchez AA, Patel MD, Rogal S, Singh GK. Reference ranges of left ventricular strain measures by two-dimensional speckle tracking echocardiography in children: a systematic review and meta-analysis. J Am Soc Echocardiogr 2016;29:209-25.

World Health Organization. Guideline: assessing and managing children at primary health-care facilities to prevent overweight and obesity in the context of the double burden of malnutrition. Updates for the integrated management of childhood illness. Geneva: World Health Organization; 2017.

Stabouli S, Polderman N, Nelms CL, Paglialonga F, Oosterveld MJS, Greenbaum LA, dkk. Assessment and management of obesity and metabolic syndrome in children with CKD stages 2 – 5 on dialysis and after kidney transplantation — clinical practice recommendations from the Pediatric Renal Nutrition Taskforce. Pediatr Nephrol 2021;37:1-20.

Yim HE, Yoo KH. Obesity and chronic kidney disease : prevalence , mechanism , and management. Clin Exp Pediatr 2021;64:511-8.

Ameer OZ. Hypertension in chronic kidney disease : What lies behind the scene. Front Pharmacol 2022;13:1-28.

Clementi A, Goh CY, Cruz DN, Granata A, Vescovo G, Ronco C. Cardiorenal syndrome Type 4: A review. Cardiorenal Med 2013;3:63-70.

Page AK Le, Nagasundaram N, Horton AE, Johnstone LM. Echocardiogram screening in pediatric dialysis and transplantation. Pediatr Nephrol 2023;38:957-74.

Ladányi Z, Bárczi A, Fábián A, Ujvári A, Cseprekál O, Kis É, dkk. Get to the heart of pediatric kidney transplant recipients : Evaluation of left- and right. Front Cardiovasc 2023;10:1–11.

Davis A, Adams D, Venkateshvaran A, Alenezi F. Speckle tracking echocardiography: What sonographers need to know? J Indian Acad Echocardiogr Cardiovasc Imaging 2017;1:133-9.

Jahn L, Kramann R, Marx N, Floege J, Becker M, Schlieper G. Speckle tracking echocardiography and all-cause and cardiovascular mortality risk in chronic kidney disease patients. Kidney Blood Press Res 2019;44:690-703.

Hassan FM, Khattab AA, Soliman MA, El RS, Feteih MGS. Left ventricular strain in pediatric patients with end ? stage renal disease. Menoufia Med J 2018;32:861-7.

Elshamaa MF, Mostafa FA, Sad IAES, Badr AM, Aem Y, Elrahim A. Left ventricular myocardial deformations in hemodialysis children by speckle tracking echocardiography. Clin Med Insights Cardiol 2020;14:1-8.

Demetgul H, Giray D, Delibas A, Hallioglu O. 2D-Speckle tracking echocardiography contributes to early identification of impaired left ventricular myocardial function in children with chronic kidney disease. Cardiol Young 2018;28:1404–9.

D’hooge J, Heimdal A, Jamal F, Kukulski T, Bijnens B, Rademakers F, dkk. Regional strain and strain rate measurements by cardiac ultrasound : Principles, implementation and limitations. Eur J Echocardiogr 2000;1:154-70.

Aldaas OM, Igata S, Raisinghani A, Kraushaar M, DeMaria AN. Accuracy of left ventricular ejection fraction determined by automated analysis of handheld echocardiograms: A comparison of experienced and novice examiners. Echocardiography 2019;00:1-7.




DOI: http://dx.doi.org/10.14238/sp25.6.2024.356-62

Refbacks

  • Saat ini tidak ada refbacks.


##submission.copyrightStatement##

##submission.license.cc.by-nc-sa4.footer##

Informasi Editorial:
Badan Penerbit Ikatan Dokter Anak Indonesia
Jl. Salemba I No 5, Jakarta 10430, Indonesia
Phone/Fax: +62-21-3912577
Email: editorial [at] saripediatri.org

Lisensi Creative Commons
Sari Pediatri diterbitkan oleh Badan Penerbit Ikatan Dokter Anak Indonesia
Ciptaan disebarluaskan di bawah Lisensi Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional.