الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Nephrotic syndrome (NS) is a common childhood kidney disease caused by impaired glomerular function, characterized by protein leakage from the blood to the urine through the glomeruli, resulting in proteinuria, hypoalbuminemia, hypercholesterolemia and generalized edema (Skálová et al., 2010).
Nephrotic syndrome (NS) in childhood is largely primary or idiopathic, although a small proportion of cases are secondary to infectious agent and other glomerular and systemic diseases. Most cases appearing in the first 3 months of life are referred to as congenital nephrotic syndrome (CNS) and are due to genetic causes (Gbadegsin and Somyer, 2008).
Idiopathic nephrotic syndrome (INS) is the most frequent form of NS in children (Davin and Rutjes, 2011).
There is an increased incidence of heart disease in patients with chronic primary nephrotic syndrome (PNS). (Qiang Qin et al, 2010).
Protein wasting and systemic inflammatory activation during PNS may contribute to cardiac remodeling and dysfunction. (Nakamura et al, 2003).
Acute afterload elevations would result in decreased relaxation rate and increased diastolic intolerance to afterload in children with PNS. (Correia pinto J et al, 2006).
In our study we aimed to evaluate right ventricle (RV) and left ventricle (LV) functions in children with Primary Nephrotic Syndrome (PNS).
This study included 30 patients with primary nephrotic syndrome(18males, 12females) their ages ranged from(4-14 years) with mean and twenty age and sex-matched normal children were also taken as a control their ages ranged from (3 – 14 years) 33.3 % of patients were Steroid responsive NS, 43.3% of patients were in relapse after remission , 16.7 patients were SDNS , and 6.7 patient were SRNS.
All children were subjected to Full history taking :name, age, sex, family history of similar conditions
Full clinical examination:general examination(temperature , pulse respiratory rate .blood pressure)
Anthropometric measurements cardiovascular, chest, abdominal, examination.
Laboratory investigations in the form of (Serum albumin ,renal function tests ,24 hour protein in urine ,serum cholesterol level. Echocardiography:
LV,RV hemodynamics were evaluated by Doppler Echocardiography
Function evaluated by using MPI(myocardil performance index) and LV function by LV end-systolic diameter, LV end-diastolic diameter, LV ejection fraction.
Results shown in Tables (1-11) and figures from one to four
There were no significant difference between patient and control groups as regard age , sex ,wt and Ht .
There were significant increase in serum cholesterol , and 24 hr protein in patient when compared with control (p 0.0001*) for each of them.
Also there were significant increase in diastolic BP and serum albumin in patients when compared with control (p 0.001* , 0.0001*) respectively.
There were no significant difference between case and control as regard LAD, , LVEDD, LVESD,LVPWD,EF and Left DT
As regard tissue echocardiographic parameters of left ventricle There were significant increase in IVRT (P 0.001* ), IVCT( P 0.006*) , MPI ( P 0.001*), DT (P 0.02*) and significant decrease in E/A Ratio( P 0.002**) between case and control groups.
As regard tissue echocardiographic pameters of the right ventricle There were significant differences between cases and controls as regard IVRT( P 0.02*), IVCT 0.02*) , MPI (0.0001**), DT (0.03*) and E/A ratio(0.0001**)
There were fair association between LVEDD and Right DT and the duration of the disease and this association is significant ( p 0.04*,0.014*) repectively.