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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Traditional and "new" cardiovascular risk markers and factors in pediatric dialysis patients

Mahmut Civilibal1, Salim Caliskan, Huseyin Oflaz

  • 1Department of Pediatric Nephrology, Istanbul University Cerrahpasa Medical Faculty, 34303 Cerrahpasa, Istanbul, Turkey. drcivilibal@hotmail.com

Pediatric Nephrology (Berlin, Germany)
|March 7, 2007
PubMed

Insights

Cardiovascular disease (CVD) in pediatric end-stage renal disease (ESRD) patients is linked to higher carotid intima-media thickness (cIMT) and left ventricular mass index (LVMI). Hypertension and anemia are key risk factors, suggesting improved management is crucial.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Medicine
  • Renal Disease Research

Background:

  • Cardiovascular disease (CVD) is the leading cause of death in pediatric end-stage renal disease (ESRD) patients.
  • Understanding cardiovascular risk markers and their predictors is crucial for this vulnerable population.

Purpose of the Study:

  • To analyze carotid intima-media thickness (cIMT), endothelium-dependent dilatation (EDD), and left ventricular mass index (LVMI) as cardiovascular risk markers in pediatric dialysis patients.
  • To identify independent risk factors for these markers in children and adolescents with ESRD.

Main Methods:

  • Study included 39 pediatric dialysis patients (15 hemodialysis, 24 peritoneal dialysis) and 15 healthy controls.
  • cIMT and EDD assessed via high-resolution ultrasound; LVMI calculated from echocardiography.
  • Statistical analysis included univariate and stepwise linear regression.

Main Results:

  • Pediatric dialysis patients showed significantly higher cIMT standard deviation scores (SDS), LVMI, total homocysteine (tHcy), and high-sensitivity C-reactive protein (hs-CRP) compared to controls.
  • EDD did not differ between groups.
  • Hemodialysis patients had higher mean hs-CRP than peritoneal dialysis patients.
  • Indexed systolic blood pressure (SBP) and hemoglobin were independent predictors of LVMI; indexed diastolic blood pressure (DBP) predicted cIMT.

Conclusions:

  • Atherosclerosis and left ventricular hypertrophy in pediatric ESRD patients are multifactorial.
  • Effective management of hypertension and anemia is essential for preventing and improving CVD in these children.

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