Comprehensive cardiovascular assessment of children with chronic kidney disease using exercise cardiac magnetic resonance imaging

Background Children with chronic kidney disease (CKD) have a significantly increased cardiovascular (CV) risk. The reasons for this remain unclear. However, abnormalities of systolic and diastolic myocardial function, the vascular system and autonomic dysfunction have been implicated. Conventional investigations like resting echocardiography offer limited assessment of the CV system (CVS). Comprehensive evaluation of the CVS using advanced cardiac magnetic resonance imaging (CMR) is feasible. Furthermore, exercise can unmask autonomic dysfunction not evident at rest. Hence, this study will use CMR to characterize CV response to isometric exercise in pediatric CKD.