Observational studyPediatric nephrology (Berlin, Germany)2025
The association between systolic and diastolic dysfunction and autonomic nervous system function in children receiving chronic hemodialysis.
Observational study in Pediatric nephrology (Berlin, Germany), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
3 citing papers in PubMed.
- Dialysis-associated cardiovascular disease risk in children: mechanism and management.Pediatric nephrology (Berlin, Germany) · 2026Review
- Pediatric Reference Limits for Holter Monitor Heart Rate Variability Parameters: Defined Using Meta-Analysis.Pediatric cardiology · 2026Article
- The association between systolic and diastolic dysfunction and autonomic nervous system function in children receiving chronic hemodialysis.Pediatric nephrology (Berlin, Germany) · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundChanges in cardiac function and structure as well as their association with the cardiac autonomic nervous system remain incompletely characterized in children with stage 5 chronic kidney disease (CKD) receiving hemodialysis (HD).
methodsA prospective observational cohort study was conducted on 40 Egyptian children with CKD on regular HD compared to 40 age- and sex-matched healthy children. All participants underwent thorough clinical examination, laboratory investigations, 24-h Holter monitoring, and 2D/4D echocardiographic study (conventional and advanced modalities). Participants were followed for mortality and morbidity over 36 months.
resultsFollowing HD sessions, CKD children showed significant reductions of left and right ventricular (LV/RV) systolic function by 2D and 4D echocardiography compared to controls. HD children had significant impairment of heart rate variability parameters (evaluated by time and frequency domains). LV/RV global longitudinal shortening (GLS) as well as tricuspid annular plane systolic excursion were closely correlated with different Holter parameters, including frequency domain parameters (including low frequency, high frequency, and LF/HF ratio), time domain parameters including percentage of differences > 50 ms between consecutive normal RR intervals (pNN50), and root-mean-square of the difference between successive normal intervals (rMSSD). Over a follow-up of 34.5 ± 16.8 months, 10 (25%) patients died. Reduced LV/RV-GLS and decreased rMSSD values were independently associated with higher mortality among HD children.
conclusionsLV and RV myocardial deformation (either 2D or 4D) primarily decreased in HD children. Altered time and frequency domain indices revealed cardiac autonomic dysfunction, evidenced by increased sympathetic activity and decreased vagal activity. Reduced LV/RV-GLS and decreased rMSSD values were independently associated with higher mortality among HD children.
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