{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:36:10Z","timestamp":1787236570775,"version":"build-2736575974"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While the presence of cardiorenal syndrome in the adult population is well-documented, there is limited understanding of cardiorenal syndrome in paediatric patients with chronic kidney disease (CKD). Our objective was to assess the prevalence of left ventricular hypertrophy, left ventricular diastolic dysfunction, and left ventricular systolic dysfunction in children with CKD. Additionally, we conducted follow-up evaluations to track the incidence of cardiac events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recruited children aged 2\u201318 years old with estimated glomerular filtration rate (eGFR) \u2264 45\u2005mL\/min\/1.73\u2005m2 or on dialysis, and performed transthoracic echocardiography to evaluate the left ventricular mass and left ventricular systolic and diastolic function. They underwent anthropometric assessment and serum measurement at baseline, and were followed up for 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 45 children recruited, 33 (73.3%) were on dialysis, 28 (84.8%) of whom were on peritoneal dialysis. The prevalences of left ventricular hypertrophy, left ventricular diastolic dysfunction, left ventricular systolic dysfunction were 42.2%, 15.6%, and 8.9%, respectively. Concomitant left ventricular diastolic dysfunction and left ventricular systolic dysfunction were present in 6.7% of children. The presence of left ventricular diastolic dysfunction was significantly associated with left ventricular hypertrophy (P &amp;lt; .001), left ventricular systolic dysfunction (P &amp;lt; .001), and higher left ventricular mass index Z score (P &amp;lt; .001). Left ventricular hypertrophy was associated with the presence of hypertension (P = .035) and inadequate blood pressure (BP) control (P = .033), while left ventricular diastolic dysfunction was associated with lower body mass index (BMI) z score (P = .01) and lower serum albumin (P = .045). Over a 6-month follow up period, 52.6% of children with left ventricular hypertrophy and 71.4% with left ventricular diastolic dysfunction developed a cardiovascular event or died.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Structural and functional cardiac changes are highly prevalent among children with CKD, putting them at significant risk of cardiovascular events and death.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/joneph\/aajaf080","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T12:25:49Z","timestamp":1767702349000},"page":"792-798","source":"Crossref","is-referenced-by-count":0,"title":["Renal Effect on Children's Heart (REACH), a prospective observational study on cardiac dysfunction among paediatric CKD patients"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8076-1456","authenticated-orcid":false,"given":"Nur Aida","family":"Adnan","sequence":"first","affiliation":[{"name":"Nephrology Unit, Department of Paediatrics, Tunku Azizah Women and Children Hospital , Kuala Lumpur ,","place":["Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yok Chin","family":"Yap","sequence":"additional","affiliation":[{"name":"Nephrology Unit, Department of Paediatrics, Tunku Azizah Women and Children Hospital , Kuala Lumpur ,","place":["Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia Bt","family":"Alias","sequence":"additional","affiliation":[{"name":"Cardiology Unit, Department of Paediatrics, Tunku Azizah Women and Children Hospital , Kuala Lumpur ,","place":["Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,5]]},"reference":[{"key":"2026082009370449100_aajaf080-B1","doi-asserted-by":"publisher","first-page":"e840","DOI":"10.1161\/CIR.0000000000000664","article-title":"Cardiorenal syndrome: classification, pathophysiology, diagnosis, and treatment strategies: a scientific statement from the American Heart Association","volume":"139","author":"Rangaswami","year":"2019","journal-title":"Circulation"},{"key":"2026082009370449100_aajaf080-B2","doi-asserted-by":"publisher","first-page":"493","DOI":"10.4103\/apc.apc_50_22","article-title":"Cardiorenal syndrome in the pediatric population: a systematic review","volume":"15","author":"Pradhan","year":"2022","journal-title":"Ann Pediatr Cardiol"},{"key":"2026082009370449100_aajaf080-B3","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1016\/j.jchf.2015.09.015","article-title":"Assessing the risk of progression from asymptomatic left ventricular dysfunction to overt heart failure: a systematic overview and meta-analysis","volume":"4","author":"Echouffo-Tcheugui","year":"2016","journal-title":"JACC Heart Fail"},{"key":"2026082009370449100_aajaf080-B4","doi-asserted-by":"publisher","first-page":"1461","DOI":"10.1111\/j.1523-1755.2004.00525.x","article-title":"Impaired left ventricular diastolic function in children with chronic renal failure","volume":"65","author":"Mitsnefes","year":"2004","journal-title":"Kidney Int"},{"key":"2026082009370449100_aajaf080-B5","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1093\/eurjhf\/hfq121","article-title":"Epidemiology and clinical course of heart failure with preserved ejection fraction","volume":"13","author":"Lam","year":"2011","journal-title":"Eur J Heart Fail"},{"key":"2026082009370449100_aajaf080-B6","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/s42399-022-01347-2","article-title":"Cardiovascular alterations and structural changes in the setting of chronic kidney disease: a review of cardiorenal syndrome type 4","volume":"5","author":"Minciunescu","year":"2023","journal-title":"SN Compr Clin Med"},{"key":"2026082009370449100_aajaf080-B7","doi-asserted-by":"publisher","first-page":"102708","DOI":"10.1016\/j.eclinm.2024.102708","article-title":"4C and 3H study investigators. 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