BACKGROUND: Measures of aortic stiffness--aortic pulse wave velocity (PWV) and augmentation index (AIx)--have been shown to be powerful predictors of survival in adult haemodialysis (HD) patients. Very few data have been reported regarding arterial stiffness in paediatric renal populations. METHODS: PWV and aortic AIx were determined from contour analysis of arterial waveforms recorded by applanation tonometry using a SphygmoCor device in 14 children on HD (age = 14.1 years) and in 15 age, height matched children controls. RESULTS: Pre-HD AIx (29.7 +/- 15.4%) and PWV (6.6 +/- 1.0 m/s) were significantly higher compared with children controls (8.3 +/- 8.0% and 5.4 +/- 0.6 m/s, respectively, P < 0.0001). The only significant difference between normal and HD children was BP level: 103/61 vs 114/72 mmHg, P < 0.05. In children of HD patients, a multiple linear regression model including BP, age, height, weight, Ca and P levels as independent variables accounted for 57% of the variability in AIx. Dialysis had no impact on AIx (post-HD: 28.5 +/- 12.7%) or on PWV (post-HD: 6.7 +/- 0.8 m/s). CONCLUSIONS: We show, in this first-ever report of increased arterial stiffness in children on dialysis, that end-stage renal disease is associated with abnormalities in arterial wall elastic properties, comparable with adult levels, even in childhood. Most importantly, the absence of a discernible amelioration with dialysis implies that purely structural and not functional alterations lie behind the increased arterial stiffness.
BACKGROUND: Measures of aortic stiffness--aortic pulse wave velocity (PWV) and augmentation index (AIx)--have been shown to be powerful predictors of survival in adult haemodialysis (HD) patients. Very few data have been reported regarding arterial stiffness in paediatric renal populations. METHODS: PWV and aortic AIx were determined from contour analysis of arterial waveforms recorded by applanation tonometry using a SphygmoCor device in 14 children on HD (age = 14.1 years) and in 15 age, height matched children controls. RESULTS: Pre-HD AIx (29.7 +/- 15.4%) and PWV (6.6 +/- 1.0 m/s) were significantly higher compared with children controls (8.3 +/- 8.0% and 5.4 +/- 0.6 m/s, respectively, P < 0.0001). The only significant difference between normal and HDchildren was BP level: 103/61 vs 114/72 mmHg, P < 0.05. In children of HDpatients, a multiple linear regression model including BP, age, height, weight, Ca and P levels as independent variables accounted for 57% of the variability in AIx. Dialysis had no impact on AIx (post-HD: 28.5 +/- 12.7%) or on PWV (post-HD: 6.7 +/- 0.8 m/s). CONCLUSIONS: We show, in this first-ever report of increased arterial stiffness in children on dialysis, that end-stage renal disease is associated with abnormalities in arterial wall elastic properties, comparable with adult levels, even in childhood. Most importantly, the absence of a discernible amelioration with dialysis implies that purely structural and not functional alterations lie behind the increased arterial stiffness.
Authors: Beth A Kozel; Joshua R Danback; Jessica L Waxler; Russell H Knutsen; Lisa de Las Fuentes; Gyorgy S Reusz; Eva Kis; Ami B Bhatt; Barbara R Pober Journal: Hypertension Date: 2013-10-14 Impact factor: 10.190
Authors: Mohammed Alghamdi; Astrid M De Souza; Colin T White; M Terri Potts; Bradley A Warady; Susan L Furth; Thomas R Kimball; James E Potts; George G S Sandor Journal: Pediatr Cardiol Date: 2013-02-05 Impact factor: 1.655
Authors: Stephanie S DeLoach; Lawrence J Appel; Jing Chen; Marshall M Joffe; Crystal A Gadegbeku; Emile R Mohler; Afshin Parsa; Kalyani Perumal; Mohammed A Rafey; Susan P Steigerwalt; Valerie Teal; Raymond R Townsend; Sylvia E Rosas Journal: Am J Hypertens Date: 2009-09-24 Impact factor: 2.689
Authors: Rukshana Shroff; Arianna Dégi; Andrea Kerti; Eva Kis; Orsolya Cseprekál; Kálmán Tory; Attila J Szabó; George S Reusz Journal: Pediatr Nephrol Date: 2012-10-16 Impact factor: 3.714