Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-23T11:19:40.008Z Has data issue: false hasContentIssue false
  • English
  • Français

Effect of high-dose oral cholecalciferol on cardiac mechanics in children with chronic kidney disease

Published online by Cambridge University Press:  03 August 2017

Murat Deveci ,
Mehmet Baha Aytaç ,
Gürkan Altun ,
Özlem Kayabey  and
Kadir Babaoğlu
Murat Deveci*
Affiliation:
Department of Pediatric Cardiology, Kocaeli University, Medical Faculty, Kocaeli, Turkey
Mehmet Baha Aytaç
Affiliation:
Department of Pediatric Nephrology, Kocaeli University, Medical Faculty, Kocaeli, Turkey
Gürkan Altun
Affiliation:
Department of Pediatric Cardiology, Derince Training and Research Hospital, KocaeliTurkey
Özlem Kayabey
Affiliation:
Department of Pediatric Cardiology, Kocaeli University, Medical Faculty, Kocaeli, Turkey
Kadir Babaoğlu
Affiliation:
Department of Pediatric Cardiology, Kocaeli University, Medical Faculty, Kocaeli, Turkey
*
Correspondence to: M. Deveci, MD, Department of Pediatric Cardiology, Kocaeli University, Medical Faculty, Umuttepe Campus, 41020 Izmit, Kocaeli, Turkey. Tel: +90 533 542 16 67; Fax: +90 262 303 70 03; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Cardiovascular factors are an important cause of mortality in chronic kidney disease, and vitamin-D deficiency is common in this patient population. Therefore, we aimed to investigate the effect of oral cholecalciferol on cardiac mechanics in children with chronic kidney disease. A total of 41 children with chronic kidney disease – the patient group – and 24 healthy subjects – the control group – free of any underlying cardiac or renal disease with low 25-hydroxyvitamin-D3 levels were evaluated by conventional tissue Doppler imaging and two-dimensional speckle-tracking echocardiography, both at baseline and following Stoss vitamin-D supplementation. Left ventricular strain and strain rate values were compared between the study groups. Initial longitudinal and radial strain as well as strain rate values of the left ventricle were significantly lower in patients. After vitamin-D supplementation, these improved significantly in patients, whereas no significant change was observed in the control group. Our study showed that, although conventional and tissue Doppler imaging methods could not determine any effect, two-dimensional speckle-tracking echocardiography revealed the favourable effects of high-dose cholecalciferol on cardiac mechanics, implying the importance of vitamin-D supplementation in children with chronic kidney disease.

Keywords

Childrenchronic kidney diseasetwo-dimensional speckle-tracking echocardiography25-hydroxyvitamin-D3
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 9 , November 2017 , pp. 1807 - 1814
Check for updates
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Parekh, RS, Carrol, CE, Wolfe, RA, Port, FK. Cardiovascular mortality in children and young adults with end stage kidney disease. J Pediatr 2002; 141: 191–197.CrossRefGoogle Scholar
2. Aytaç, MB, Deveci, M, Bek, K, Kayabey, Ö, Ekinci, Z. Effect of cholecalciferol on local arterial stiffness and endothelial dysfunction in children with chronic kidney disease. Pediatr Nephrol 2016; 31: 267–277.Google Scholar
3. Chitalia, N, Recio-Mayoral, A, Kaski, JC, Banerjee, D. Vitamin D deficiency and endothelial dysfunction in non-dialysis chronic kidney disease patients. Atherosclerosis 2012; 220: 265–268.Google Scholar
4. Pilz, S, Tomaschitz, A, Friedl, C, et al. Vitamin D status and mortality in chronic kidney disease. Nephrol Dial Transplant 2011; 26: 3603–3609.CrossRefGoogle ScholarPubMed
5. Zittermann, A, Schleithoff, SS, Tenderich, G, Berthold, HK, Körfer, R, Stehle, P. Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure? J Am Coll Cardiol 2003; 41: 105–112.Google Scholar
6. Geyer, H, Caracciolo, G, Abe, H, et al. Assessment of myocardial mechanics using speckle tracking echocardiography: fundamentals and clinical applications. J Am Soc Echocardiogr 2010; 23: 351–369.Google Scholar
7. Hassanin, N, Alkemary, A. Early detection of subclinical uremic cardiomyopathy using two-dimensional speckle tracking echocardiography. Echocardiography 2016; 33: 527–536.CrossRefGoogle ScholarPubMed
8. National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in children with chronic kidney disease. Am J Kidney Dis 2003; 42 (Suppl 3): S1–S201.CrossRefGoogle Scholar
9. Schwartz, GJ, Brion, LP, Spitzer, A. The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am 1987; 34: 571–590.Google Scholar
10. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 2002; 39 (Suppl 1): S1–S266.Google Scholar
11. Lang, RM, Bierig, M, Devereux, RB, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr 2005; 18: 1440–1463.CrossRefGoogle Scholar
12. Altun, G, Babaoğlu, K, Binnetoğlu, K, Özsu, E, Yeşiltepe Mutlu, RG, Hatun, Ş. Subclinical left ventricular longitudinal and radial systolic dysfunction in children and adolescents with type1 diabetes mellitus. Echocardiography 2016; 33: 1032–1039.CrossRefGoogle Scholar
13. Green, D, Roberts, PR, New, DI, Kalra, PA. Sudden cardiac death in hemodialysis patients: an in-depth review. Am J Kidney Dis 2011; 57: 921–929.Google Scholar
14. Kramann, R, Erpenbeck, J, Schneider, RK, et al. Speckle tracking echocardiography detects uremic cardiomyopathy early and predicts cardiovascular mortality in ESRD. J Am Soc Nephrol 2014; 25: 2351–2365.CrossRefGoogle ScholarPubMed
15. Patange, AR, Valentini, RP, Du, W, Pettersen, MD. Vitamin D deficiency and arterial wall stiffness in children with chronic kidney disease. Pediatr Cardiol 2012; 33: 122–128.CrossRefGoogle ScholarPubMed
16. Mitsnefes, MM, Daniels, SR, Schwartz, SM, Meyer, RA, Khoury, P, Strife, CF. Severe left ventricular hypertrophy in pediatric dialysis: prevalence and predictors. Pediatr Nephrol 2000; 14: 898–902.Google Scholar
17. Mitsnefes, MM, Kimball, TR, Kartal, J, et al. Cardiac and vascular adaptation in pediatric patients with chronic kidney disease: role of calciumphosphorus metabolism. Am Soc Nephrol 2005; 16: 2796–2803.Google Scholar
18. Mitsnefes, MM, Kimball, TR, Kartal, J, et al. Progression of left ventricular hypertrophy in children with early chronic kidney disease: 2-year follow-up study. J Pediatr 2006; 149: 671–675.Google Scholar
19. Ali, FN, Arguelles, LM, Langman, CB, Price, HE. Vitamin D deficiency in children with chronic kidney disease: uncovering an epidemic. Pediatrics 2009; 123: 791–796.Google Scholar
20. Wolf, M, Shah, A, Gutierrez, O, et al. Vitamin D levels and early mortality among incident hemodialysis patients. Kidney Int 2007; 72: 1004–1013.Google Scholar
21. Mehrotra, R, Kermah, DA, Salusky, IB, et al. Chronic kidney disease, hypovitaminosis D, and mortality in the United States. Kidney Int 2009; 76: 977–983.CrossRefGoogle ScholarPubMed
22. O’Connell, TD, Simpson, RU. Immunochemical identification of the 1,25-dihydroxyvitamin D3 receptor protein in human heart. Cell Biol Int 1996; 20: 621–624.Google Scholar
23. Kim, HW, Park, CW, Shin, YS, et al. Calcitriol regresses cardiac hypertrophy and QT dispersion in secondary hyperparathyroidism on hemodialysis. Nephron Clin Pract 2006; 102: 21–29.CrossRefGoogle ScholarPubMed
24. Matias, PJ, Jorge, C, Ferreira, C, et al. Cholecalciferol supplementation in hemodialysis patients: effects on mineral metabolism, inflammation, and cardiac dimension parameters. Clin J Am Soc Nephrol 2010; 5: 905–911.CrossRefGoogle ScholarPubMed
25. Adamu, U, Schmitz, F, Becker, M, Kelm, M, Hoffman, R. Advanced speckle tracking echocardiography allowing a three-myocardial layer specific analysis of deformation parameters. Eur J Echocardiogr 2009; 10: 303–308.Google Scholar
26. Saghir, M, Areces, M, Makan, M. Strain rate imaging differentiates hypertensive cardiac hypertrophy from physiologic cardiac hypertrophy (athlete’s heart). J Am Soc Echocardiogr 2007; 20: 151–157.Google Scholar
27. Lagies, R, Beck, BB, Hoppe, B, et al. Inhomogeneous longitudinal cardiac rotation and impaired left ventricular longitudinal strain in children and young adults with end-stage renal failure undergoing hemodialysis. Echocardiography 2015; 32: 1250–1260.Google Scholar
28. Sunbul, M, Bozbay, M, Mammadov, C, et al. Effect of vitamin D deficiency and supplementation on myocardial deformation parameters and epicardial fat thickness in patients free of cardiovascular risk. Int J Cardiovasc Imaging 2015; 31: 765–772.Google Scholar
29. Hari, P, Gupta, N, Hari, S, Gulati, A, Mahajan, P, Bagga, A. Vitamin D insufficiency and effect of cholecalciferol in children with chronic kidney disease. Pediatr Nephrol 2010; 25: 2483–2488.Google Scholar
30. Belostotsky, V, Mughal, Z, Webb, NJA. A single high dose of ergocalciferol can be used to boost 25-hydroxyvitamin D levels in children with kidney disease. Pediatr Nephrol 2009; 24: 625–626.Google Scholar