Effect of kidney transplantation on heart conduction disturbances in children treated with chronic hemodialysis--a pilot study

Pediatr Transplant. 2011 Dec;15(8):835-43. doi: 10.1111/j.1399-3046.2011.01588.x.

Abstract

Aim of the study was to assess the effect of KT on heart conduction in HD children. Non-invasive electrocardiographic method of BSPM was used. Isochrone maps, presenting a VAT distribution, were taken from eight HD patients and 26 normal subjects. Patients were divided into two groups: I--three children were HD <12 months prior to KT; II--five children were HD >12 months prior to KT. After KT, the groups were marked as IP and IIP. Serum iPTH and phosphate levels were significantly higher in both HD groups than in controls, with a considerable normalization after transplantation. HD patients demonstrated neither conduction abnormalities on ECG nor left ventricular hypertrophy. Group-mean VAT maps revealed: I and II--similar patterns of complete LBBB; IP--partial normalization to a pattern of anterior fascicle block; IIP--preserved pattern of LBBB. Intraventricular conduction disturbances found in HD children using BSPM were alleviated by KT. Short HD therapy increases a chance of conduction disturbances regression after KT, contrary to the longer HD treatment. BSPM is more sensitive than standard ECG in detecting heart conduction impairments in the HD patients.

MeSH terms

  • Adolescent
  • Arrhythmias, Cardiac / diagnosis
  • Arrhythmias, Cardiac / etiology*
  • Body Surface Potential Mapping*
  • Bundle-Branch Block / diagnosis
  • Bundle-Branch Block / etiology
  • Child
  • Electrocardiography
  • Female
  • Humans
  • Kidney Failure, Chronic / surgery
  • Kidney Failure, Chronic / therapy*
  • Kidney Transplantation*
  • Male
  • Renal Dialysis / adverse effects*