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Hemodialysis acutely impairs endothelial function in children
Marc R Lilien1, Hein A Koomans, Cornelis H Schröder
1Department of Pediatric Nephrology, University Medical Center Utrecht, PO Box 80590, 3508 CA Utrecht, The Netherlands. m.lilien@wkz.azu.nl
Pediatric Nephrology (Berlin, Germany)
|January 1, 2005
Summary
Children with end-stage renal disease (ESRD) undergoing hemodialysis exhibit endothelial dysfunction. A hemodialysis session further impairs vascular function, increasing cardiovascular risk in pediatric patients.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Health
- Vascular Biology
Background:
- Cardiovascular disease is a leading cause of mortality in end-stage renal disease (ESRD) patients, including children.
- Endothelial dysfunction is an early marker of atherosclerosis, a condition prevalent in ESRD.
- Limited research exists on hemodialysis effects on pediatric endothelial function.
Purpose of the Study:
- To compare endothelial function in children with ESRD on hemodialysis versus healthy children.
- To assess the acute impact of a hemodialysis session on endothelial function in pediatric ESRD patients.
Main Methods:
- Non-invasive ultrasound assessment of brachial artery flow-mediated dilation (FMD) in 10 children with ESRD and 10 healthy controls.
- Measurements taken before and after a standard hemodialysis session in the ESRD group.
Main Results:
- Children with ESRD on hemodialysis showed significantly lower baseline FMD (6.0%) compared to healthy controls (14.2%).
- A hemodialysis session further reduced FMD in ESRD patients to 1.8%.
- No significant changes were observed in brachial artery diameter or distensibility.
Conclusions:
- Pediatric patients with ESRD on hemodialysis have significant endothelial dysfunction.
- Hemodialysis acutely exacerbates endothelial dysfunction in these children.
- Repeated vascular insults from hemodialysis may contribute to the elevated cardiovascular risk in pediatric ESRD.