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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

Effects of bone and mineral metabolism on arterial elasticity in chronic renal failure

Eva Kis1, Orsolya Cseprekál, Edina Bíró

  • 1First Department of Pediatrics, Semmelweis University, Budapest Bókay János u. 53-54, 1083, Hungary.

Pediatric Nephrology (Berlin, Germany)
|September 19, 2009
PubMed

Insights

Mineral and bone metabolism significantly impact arterial stiffness (Ast) in children with kidney disease. Increased bone turnover and calcification potential correlate with higher Ast in dialyzed children, suggesting kidney transplantation may improve outcomes.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Health
  • Mineral and Bone Disorders

Background:

  • Arterial stiffness (Ast) is a predictor of cardiovascular mortality, often exacerbated by vascular calcification.
  • Pulse wave velocity (PWV) is a key indicator of Ast.
  • Mineral and bone metabolism disturbances are common in children with chronic kidney disease.

Purpose of the Study:

  • To investigate the influence of mineral and bone metabolism on arterial stiffness in pediatric patients undergoing dialysis (D) and kidney transplantation (Tx).
  • To assess the roles of fetuin-A, calcium (Ca), phosphate (P), and bone markers in arterial stiffness.
  • To explore the relationship between calcification potential (Ca x P/fetuin-A ratio) and Ast.

Main Methods:

  • Measured normalized pulse wave velocity/height (PWV/h) in 11 dialyzed and 17 transplanted children using applanation tonometry.
  • Analyzed serum levels of Ca, P, fetuin-A, bone-specific alkaline phosphatase (BALP), and beta-CrossLaps (beta).
  • Calculated the Ca x P/fetuin-A ratio and assessed cumulative calcitriol dosage.

Main Results:

  • Fetuin-A levels were lower in dialyzed and transplanted children compared to controls.
  • Dialyzed children exhibited higher bone markers and Ca x P/fetuin-A ratios than transplanted children and controls.
  • In dialyzed patients, PWV/h correlated significantly with Ca x P/fetuin-A and BALP. In transplanted patients, prior calcitriol dose correlated with PWV/h.

Conclusions:

  • Increased bone turnover and calcification potential are linked to arterial stiffness in pediatric kidney disease patients.
  • Kidney transplantation may offer benefits for arterial stiffness compared to dialysis, though further research is warranted.
  • Disturbed mineral and bone metabolism plays a crucial role in the development of arterial stiffness in this population.

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