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Objective: To identify the echocardiographic abnormalities in children with chronic kidney disease on maintenance hemodialysis. Study Design: Prospective longitudinal study. Place and Duration of Study: Hemodialysis unit of Department of Pediatric Nephrology, The Children’s Hospital and Institute of Child Health, Lahore from Jun to Nov 2020. Methodology: A total of 75 children of chronic kidney disease on hemodialysis were included. Blood and urine tests, chest x-ray and transthoracic echo cardio-grapy were performed to assess the cardiac morphological and functional abnormalities. Results: The mean age of patients was 12.14 ± 2.18 years with 54 (72%) males and 21 (28%) females. The mean duration of hemodialysis was 22.54 ± 17.01 months with mean urea reduction ratio (URR) (%) 65.58 ± 4.31 and mean Kt/v 1.3 ± 0.1. Hypertension was noted in 70 (93.3%) patients with mean systolic and diastolic blood pressure 134.07 ± 10.64 and 89.13 ± 6.78 mmHg, respectively. The echocardiography revealed the mean ejection fraction of 58.02 ± 12.40 with mild systolic and diastolic dysfunction noted in 48 (64%) patients, pericardial effusion in 23 (30.7%) cases and left ventricular hypertrophy (LVH) in 52 (69.3%) cases. Conclusion: As the frequency of left ventricular hypertrophy (LVH) was noted to be high in our chronic kidney disease patients on hemodialysis, there is a need to implement echocardiographic screening of these patients at regular intervals to identify and rectify cardiac complications early.

Nephrotic syndrome is a clinical syndrome defined by massive proteinuria (greater than 40 mg/m2/hour) responsible for hypoalbuminemia (less than 30 g/L) resulting in oedema and hyperlipidaemia. Objective of the study was to compare the frequency of relapse rate with short and long duration steroid therapy in Nephrotic syndrome. It was a Quasiexperimental control group design, conducted at the Department of Paediatric Nephrology, The Children's Hospital and Institute of Child Health, Lahore. Duration of study: One year.The data of 150 patients with steroid sensitive nephrotic syndrome was included with clinical presentation and diagnostic investigations. The children were randomly divided into long and short duration steroid treatment groups. Outcome was determined in terms of relapse rate after achieving remission with both treatment strategies. Independent sample t test was applied to compare the outcome in both groups with p≤0.05 considered as significant. Data was stratified for all the effect modifiers like age and gender and poststratification chi square test was applied to see the effect on the outcome, taking p≤0.05 as significant.The relapse rate of the disease was 0.8±0.72 per year in short-duration group and 1.28±0.61 per year in subjects receiving long-duration steroids, and difference between the two groups was found to be statistically significant (p0.001). The relapse rate was less in the short duration therapy group as compared to the long duration therapy 62.7% (n=47) patients in group A had one or more relapses of the disease within one year of follow up in contrast to 94.7% (n=71) children in group B (p0.001).Patients receiving short duration steroid therapy showed a lower relapse rate as compared to those who were administered long term steroids.