{"id":"8102eab6fc1d","type":"article","url":"https://hartvaat.nl/2026/09/21/abnormale-myocardiale-strain-op-cmr-bij-kinderen-met-gevorderde-chronische-nierz/","title":"Abnormale myocardiale strain op CMR bij kinderen met gevorderde chronische nierziekte — CKiD","title_en":"Left ventricular remodeling by cardiac magnetic resonance in children with advanced chronic kidney disease: an analysis of the Chronic Kidney Disease in Children (CKiD) study.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["cardioloog","internist"],"tags":[],"journal":"Pediatric nephrology (Berlin, Germany)","doi":"10.1007/s00467-026-07538-6","source_url":"https://doi.org/10.1007/s00467-026-07538-6","authors":["Loretta Z Reyes","Jennifer Roem","Sean M Lang","Michael D Taylor","Bradley A Warady","Susan L Furth","Mark Mitsnefes"],"significance":4,"published":"2026-09-29","source_date":"2026-09-21","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/wat-is-chronische-nierziekte/","https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/"],"congress":"","summary_en":"An exploratory analysis of the CKiD cohort reveals that abnormal myocardial strain on cardiac MRI is highly prevalent (60–68%) in children with advanced chronic kidney disease (eGFR <30), despite clinically significant systolic dysfunction being rare (6%). These strain abnormalities correlate independently with higher left ventricular mass index. The findings highlight the potential of advanced imaging to detect subclinical cardiorenal damage, underscoring the importance of early cardiovascular risk assessment in severe CKD.","created":"2026-09-22T01:20:14Z","updated":"2026-09-22T01:20:14Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een exploratieve analyse binnen de CKiD-cohortstudie toont aan dat bij kinderen met gevorderde chronische nierziekte (eGFR <30) abnormale myocardiale strain op CMR zeer prevalent is (60–68%), terwijl klinisch significante systolische dysfunctie zeldzaam blijft (6%). Deze strainafwijkingen correleren onafhankelijk met een verhoogde linkerventrikelmassaindex. Het resultaat benadrukt dat geavanceerde beeldvorming subklinische cardiorenale schade kan opsporen, wat relevant is voor het risicomanagement bij patiënten met een ernstige nierfunctievermindering.","abstract_original":"BACKGROUND: Children with advanced chronic kidney disease (CKD) have a high burden of cardiovascular disease (CVD). Left ventricular hypertrophy (LVH) and abnormal myocardial strain are prevalent in CKD patients and confer increased cardiovascular morbidity. While echocardiography is conventionally used to assess myocardial function, cardiovascular magnetic resonance imaging (CMR) provides superior assessment of myocardial morphology and function, including myocardial strain. We conducted an exploratory analysis of the CMR features of children with advanced CKD in the Chronic Kidney Disease in Children (CKiD) study to evaluate the relationship between CKD and CVD severity. METHODS: A subset of CKiD patients with eGFR < 30 ml/min/1.73 m2 underwent CMR. Left ventricular mass indexed to body surface area (LV mass index), global peak longitudinal strain (GLS), and global peak circumferential strain (GCS) were the primary continuous outcomes. We quantified associations between clinical/demographic risk factors with LV mass index, GLS, and GCS using linear regression, and utilized a variant of stepwise regression to identify combinations of independent variables that were most associated with the primary outcomes. RESULTS: We analyzed 47 CKiD participants (median age, 16 years; median eGFR, 25 ml/min|1.73 m2). LVH was prevalent at 13%. GLS and GCS > 95th percentile of published normative thresholds was prevalent at 60% and 68%, respectively. Only 6% of participants had clinically significant abnormally low absolute GLS (< 15). Lower GLS and GCS were independently associated with higher LV mass index. CONCLUSIONS: Myocardial strain > 95th percentile of published normal thresholds on CMR was highly prevalent and related to higher LV mass index in the CKiD cohort with advanced CKD."}