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Carotid intima-media thickness in children with end-stage renal disease on dialysis

A Gheissari1, M Sirous, T Hajzargarbashi

  • 1Department of Pediatric Nephrology, Isfahan University of Medical Sciences, Isfahan, Iran.

Indian Journal of Nephrology
|June 11, 2010
PubMed

Insights

Cardiovascular issues are prevalent in children with end-stage renal disease (ESRD). Intima-media thickness (IMT-C) is a potential early marker for atherosclerosis, correlating with N-PTH and alkaline phosphatase levels in these patients.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Research
  • Diagnostic Markers

Background:

  • Cardiovascular disease is a leading cause of mortality in end-stage renal disease (ESRD) patients.
  • Limited data exists on early atherosclerosis markers like intima-media thickness (IMT) in pediatric ESRD patients undergoing dialysis.
  • This study investigates carotid (IMT-C) and bulb (IMT-B) intima-media thickness in children on hemodialysis (HD) and peritoneal dialysis (PD).

Purpose of the Study:

  • To assess carotid and bulb intima-media thickness (IMT-C and IMT-B) as early atherosclerosis markers in pediatric ESRD patients.
  • To identify factors associated with IMT in children on hemodialysis (HD) and peritoneal dialysis (PD).
  • To compare IMT measurements between HD and PD pediatric patients.

Main Methods:

  • Retrospective analysis of 16 pediatric ESRD patients (<18 years) on HD (n=9) and PD (n=7).
  • Biochemical markers including serum von Willebrand factor (vWF), homocysteine, apo lipoproteins A and B, and C-reactive protein (CRP) were measured.
  • Carotid (IMT-C) and bulb (IMT-B) intima-media thickness were measured using ultrasound.

Main Results:

  • Significant differences in cholesterol, triglycerides, apo A, apo B, CRP, vWF, homocysteine, and IMT-C were observed in ESRD patients.
  • Mean systolic blood pressure was significantly higher in the HD group compared to the PD group.
  • Partial correlation, adjusted for age, revealed significant associations between IMT-C and N-PTH and serum alkaline phosphatase.

Conclusions:

  • Intima-media thickness, particularly IMT-C, shows alterations in pediatric ESRD patients and correlates with specific biochemical markers.
  • Further longitudinal studies with larger sample sizes are necessary to elucidate the contributing factors to intima-media thickness in pediatric ESRD.
  • IMT-C may serve as a valuable early indicator of atherosclerosis in children with end-stage renal disease.

Keywords:
Carotid intima-media thicknesschildrenend stage renal disease

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