Zmiany w układzie krążenia u dzieci z kłębuszkowym zapaleniem nerek

Aldona Siwińska, Waldemar Bobkowski, Jacek Zachwieja, Małgorzata Piątkowska-Kopczyk, Janusz Maciejewski

Streszczenie
Introduction: In the course of glomerulonephritis (GN) the changes in circulatory system are observed. The aim of the research was the evaluation of circulatory system in children with GN (including lupus erythematosus and the other forms of GN).
Materials and methods: The sample group was 30 children with GN aged 5-14 years old (age?SD: 9.3?1.2, 14 males and 16 females). The study group consisted of 10 patients with lupus erythematosus and 20 patients with different diseases. The data from the review, physical examination of circulatory system, ECG, 24-hour Holter monitoring, chest X-Ray and Doppler echocardiography were considered. Control group consisted of 50 healthy children.
Results: Ventricular arrhythmias (Lown 1 and 2) appeared in 30% of patients with GN, supraventricular arrhythmias in slightly more then 30%. In 30% of the patients the I degree of atrio-ventricular block occurred. In children with GN the increased diameters any hypertrophy of the left ventricle (LV) occurred, of greater significance in patients with lupus GN. The diastolic malfunction of LV occurred as well. The disturbances in relaxation of the LV were found in children with GN as compared with control group. These disturbances were greater in patients with lupus GN. In 30% the pericarditis and in 15% the mild mitral regurgitation occurred.
Conclusions: 1. The children with GN require cardiological care due to common coexistence of disturbances in cardiovascular system. 2. The patients with lupus GN require extraordinary cardiological care. 3 The pericarditis, hypertrophy and the disturbances of diastolic function of LV are the most common disturbances in circulatory system in children with GN, especially with lupus GN. 4. In 30% of the patients with GN the arrhythmias, not requiring any treatment, occur. 5. The monitoring of blood pressure is required due to arterial hypertension in 60% of patients with GN.

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