关键词: 儿童, 非透析慢性肾脏病, 左心室肥厚

Abstract: Objective    To investigate the risk factors of left ventricular hypertrophy in children with chronic kidney disease （CKD） stage 2-4. Methods    A total of 132 cases of children with chronic kidney disease （stage 2-4） who had not received kidney replacement therapy were retrospectively analyzed from September 2012 to June 2023 in the Pediatric nephrology Department of Peking University First Hospital. According to the patient's medical records，CKD was graded according to the 2012 Improving Global Kidney Outcomes （KDIGO）. According to left ventricular wall thickness，132 patients were divided into two groups：left ventricular hypertrophy group （n=32） and non-left ventricular hypertrophy group （n=100）. The difference of statistical indicators between the two groups was compared，and the correlation analysis between left ventricular wall thickness and various indicators was carried out respectively. The risk factors related to CKD complicated with LVH were screened by multivariate Logistic regression analysis. The predictive value of hypertension and serum creatinine for LVH in patients with CKD was evaluated by receiver operating characteristic curve （ROC）. Results    A total of 132 eligible patients were collected，including 87 boys （65. 9%） and 45 girls （34. 1%）. The main cause of chronic kidney disease was hereditary kidney disease in 44 cases （33. 3%）. This was followed by 36 cases of glomerular disease （27. 3%），21 cases of congenital kidney and urinary tract malformation （CAKUT） （15. 9%），17 cases of renal tubule and/or renal interstitial disease （12. 9%），7 cases of tumor induced kidney damage （5. 3%） and 7 cases of unknown cause （5. 3%）. The number of hypertension cases in CKD was 58，with an incidence of 43. 94%. The incidence of hypertension in each stage was 50% in stage 2，44. 62% in stage 3，and 39. 53% in stage 4. The number of anemia cases was 94 with an incidence of 71. 2%，and the incidence of anemia in each stage was 41. 67% in stage 2，58. 46% in stage 3 and 90. 7% in stage 4. The incidence of left ventricular hypertrophy was 24. 24%. Among the hypertensive patients，39 were taking blood pressure lowering drugs，of which 24 （61. 54%） were taking angiotensin-sure lowering drugsy wa（ARBs） and/or angiotensin-converting enzyme inhibitors （ACEI）；Univariate Logistic regression analysis showed that there were significant differences in systolic blood pressure，diastolic blood pressure，serum creatinine and hypertension between the left ventricular hypertrophic group and the non-left ventricular hypertrophic group （P<0. 05）. Multivariate Logistic regression analysis showed that hypertension and increased serum creatinine were significantly correlated with left ventricular hypertrophy （OR=11. 689，1. 004，95% confidence interval 4. 039-33. 831，1. 000-1. 009，P<0. 05）. The ROC curve drawn according to the model shows that the cut-off value is 0. 33，the sensitivity is 0. 844，the specificity is 0. 7，and the area under the curve is 0. 813. Conclusion    Multivariate Logistic regression analysis showed that the risk factors of left ventricular hypertrophy in children with non-dialysis chronic kidney disease were hypertension and the increase of serum creatinine. The prediction model was suitable for the early diagnosis and prediction of ventricular septal hypertrophy in children with non-dialysis chronic kidney disease，and the prediction effect was good，which had certain clinical value. 

Key words: child, non-dialysis chronic kidney disease, left ventricular hypertrophy