Many of the young people with kidney disease the experts at Ann & Robert H. Lurie Children’s Hospital treat will develop cardiovascular disease, including heart failure, by midlife. Ideally, preventing this outcome is the goal, but it is very difficult to identify sick hearts at the earliest stages of cardiac disease using existing tests such as echocardiography. Investigating this further is Alexander Kula, MD, MHS, Attending Physician of Nephrology (Kidney Diseases) at Lurie Children’s, whose new study funded by a National Institutes of Health K23 grant will test whether measuring cardiac function with exercise may be more useful for identifying hearts at risk in young people with kidney disease.
Dr. Kula is collaborating with the cardiopulmonary exercise laboratory at Lurie Children’s to use ergometer (bike) stress echocardiogram to measure cardiac function in study participants. This clinical test, which is new to children, represents an improvement on existing protocols that used treadmills because it allows for generating real-time imaging at various stages of exercise, explained Dr. Kula. Importantly, it also allows researchers and clinicians the ability to monitor how the heart responds to increasing exercise intensity in real time. Lurie Children’s is one of the few children’s hospitals nationwide that can offer this advanced testing. “This study nicely demonstrates how Lurie Children’s fosters cross-specialty collaboration, in this case between nephrology and cardiology. As a result, patients benefit from unique expertise provided by the hospital.”
Dr. Kula, who is also Assistant Professor of Pediatrics (Nephrology) at Northwestern University Feinberg School of Medicine, reported that his team is currently halfway through recruiting patients with kidney disease for this study and will soon begin testing in healthy controls. The results of this study will represent a new strategy to test heart health for children and adolescents with kidney disease and many other conditions. The goal is to help providers taking care of young people ensure they do not overlook those who are at risk for early-onset cardiac disease in adulthood.
Pediatric research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through Stanley Manne Children’s Research Institute.
