BACKGROUND: Uremic vasculopathy, including vascular calcification, increases the risk for cardiovascular disease and mortality in chronic kidney disease (CKD) patients. We have investigated the prevalence and factors associated with vasculopathy in children undergoing peritoneal dialysis (PD) or hemodialysis (HD) in a single center. METHODS: Common carotid intima media thickness (cIMT) and its relation with demographics, biochemical parameters and medication was analyzed in 60 patients (mean age 12.9 ± 3.4 years; 27 girls) treated with PD (n = 31) or HD (n = 29) for 34 ± 34 months. Patients were divided into two groups: normal cIMT and increased cIMT. RESULTS: Mean levels of calcium, phosphate and calcium/phosphate product were in the normal range, the but parathyroid hormone level, 729 ± 670 pg/mL, was higher than the National Kidney Foundation Kidney Disease Outcome Quality Iniative (K/DOQI) recommendations. Twenty-nine patients had increased cIMT, which was associated with time on dialysis of >2 years, hypercalcemia, higher daily dose of calcitriol and HD (vs. PD). In the multivariate analysis, accounting for time on dialysis, HD persisted as a risk for increased cIMT. CONCLUSIONS: The prevalence of increased cIMT in children on dialysis is similar to that reported in adults with CKD and increased with time on dialysis. HD was associated with increased cIMT, independently of time on dialysis; however, the results should be interpreted with caution due to the possible impact of confounding factors. These results underline the need to monitor and, if possible, prevent and treat increased cIMT in children on dialysis.
BACKGROUND:Uremic vasculopathy, including vascular calcification, increases the risk for cardiovascular disease and mortality in chronic kidney disease (CKD) patients. We have investigated the prevalence and factors associated with vasculopathy in children undergoing peritoneal dialysis (PD) or hemodialysis (HD) in a single center. METHODS: Common carotid intima media thickness (cIMT) and its relation with demographics, biochemical parameters and medication was analyzed in 60 patients (mean age 12.9 ± 3.4 years; 27 girls) treated with PD (n = 31) or HD (n = 29) for 34 ± 34 months. Patients were divided into two groups: normal cIMT and increased cIMT. RESULTS: Mean levels of calcium, phosphate and calcium/phosphate product were in the normal range, the but parathyroid hormone level, 729 ± 670 pg/mL, was higher than the National Kidney Foundation Kidney Disease Outcome Quality Iniative (K/DOQI) recommendations. Twenty-nine patients had increased cIMT, which was associated with time on dialysis of >2 years, hypercalcemia, higher daily dose of calcitriol and HD (vs. PD). In the multivariate analysis, accounting for time on dialysis, HD persisted as a risk for increased cIMT. CONCLUSIONS: The prevalence of increased cIMT in children on dialysis is similar to that reported in adults with CKD and increased with time on dialysis. HD was associated with increased cIMT, independently of time on dialysis; however, the results should be interpreted with caution due to the possible impact of confounding factors. These results underline the need to monitor and, if possible, prevent and treat increased cIMT in children on dialysis.
Authors: Mieczyslaw Litwin; Elke Wühl; Claudia Jourdan; Anna Niemirska; Jens P Schenk; Katarzyna Jobs; Ryszard Grenda; Zbigniew T Wawer; Pawel Rajszys; Otto Mehls; Franz Schaefer Journal: Nephrol Dial Transplant Date: 2008-03-14 Impact factor: 5.992
Authors: Abelardo Aguilera; José A Sánchez-Tomero; María A Bajo; Maria L Ruiz-Caravaca; Vicente Alvarez; Gloria del Peso; Angel Herranz; Maria V Cuesta; María J Castro; Rafael Selgas Journal: Adv Perit Dial Date: 2003
Authors: Juan Antonio Garcia-Bello; Rita A Gómez-Díaz; Alicia Contreras-Rodríguez; Juan O Talavera; Rafael Mondragón-González; Lorena Sanchez-Barbosa; Margarita Diaz-Flores; Adan Valladares-Salgado; Juan Manuel Gallardo; Alejandra Aguilar-Kitsu; Jesus Lagunas-Munoz; Niels H Wacher Journal: Pediatr Nephrol Date: 2014-02 Impact factor: 3.714
Authors: Seung Seok Han; Dong Ryeol Ryu; Kwon Wook Joo; Chun Soo Lim; Yong Lim Kim; Shin Wook Kang; Yon Su Kim; Dong Ki Kim Journal: J Korean Med Sci Date: 2017-09 Impact factor: 2.153