ELECTRICAL CARDIOMETRY AND SERUMTHROMBOMODULIN FOR EVALUATION OF CARDIOVASCULAR RISK IN HAEMODIALYSIS CHILDREN

Background: Pediatric haemodialysis cases have a high incidence of cardiovascular morbimortality. Endothelial dysfunction (ED) is present at early stages of chronic kidney disease (CKD). Electrical cardiometry (EC) has been recommended as a safe, accurate, and reproducible hemodynamic measurement technique in children and infants. Through the production of substances like nitric oxide (NO), prostacyclin, thrombomodulin (TM), and tissue plasminogen activator (TPA), they control vasodilatation, fibrinolysis, and thrombosis. Objectives:To evaluate whether EC can detect cardiac output (COP) in children undergoing haemodialysis and to assess whether thrombomodulin accurately reflects the cardiac dysfunction in those patients.Methods:This is acase-control observational study includes 45 children on regular haemodialysis admitted at haemodialysis unit and from outpatient clinic of Al-Zahraa University Hospital during the period from November 2021-December 2022 and 45 children with matched age and sex as controls.Moreover, 45 apparently healthy with matched age and sex-matched children were selected as a control group. We investigated the serum level of thrombomodulin by using Human Thrombomodulin ELISA Kits in addition to routine laboratory investigations and electrical cardiometry for assessment of some parameters of both groups. Results:There was a significant decrease in Hb level, platelets counts and TLC, while there was a significant increase in serum thrombomodulin levels in CKD patients on regular haemodialysis than the control group. Highly significant increase of electrical cardiometry regarding (HR, SV, CO, CI, TFC, ICON, VIC, PEP, STR) in CKD patients on regular haemodialysis than the control group < /em> Conclusion:Children with CKD on regular haemodialysis have had a significant rise in the mean values of their cardiac markers and serum thrombomodulin level. There was a non-significant correlation between thrombomodulin serum level and electrical cardiometry.