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Updated: Feb 24, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Cardiovascular risk factors and mortality in children with chronic kidney disease
Abdullahi Mudi1, Caroline Dickens, Cecil Levy
1Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Paediatrics, Bayero University, Kano, Nigeria. abdulmudi@gmail.com.
Insights
Cardiovascular risk factors are common in children with chronic kidney disease (CKD), especially anemia. Early screening and intervention for these factors in pediatric CKD patients may reduce mortality.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Health in Children
- Chronic Kidney Disease Research
Background:
- Cardiovascular disease (CVD) development begins in childhood for patients with chronic kidney disease (CKD).
- Cardiovascular risk factors (CVRFs) significantly influence CVD progression in pediatric CKD.
- Understanding CVRF prevalence is crucial for managing long-term health in children with CKD.
Purpose of the Study:
- To determine the prevalence of CVRFs in children across all stages of CKD.
- To investigate the association between CVRFs and mortality in pediatric patients undergoing chronic dialysis.
- To identify key risk factors contributing to adverse outcomes in this population.
Main Methods:
- A comparative cross-sectional study involving 106 children (aged 5-18) with various stages of CKD.
- Clinical assessments included medical history, physical examination, and laboratory tests (serum creatinine, urea, albumin, lipids, hemoglobin, C-reactive protein).
- Urine analysis for proteinuria and detailed assessment of mineral bone metabolism were performed.
Main Results:
- Anemia was the most prevalent CVRF (39.6%), significantly higher in the dialysis group (77.8%).
- Other identified CVRFs included hypertension, proteinuria, hypercholesterolemia, and dysregulated mineral bone metabolism.
- Seven deaths occurred in the dialysis group, primarily due to severe hypertension and intracranial bleeding; modifiable factors like high total cholesterol and low albumin were noted in deceased patients.
Conclusions:
- CVRFs are present even in the early stages of CKD, prior to significant GFR decline.
- Routine screening for CVRFs in children with CKD is recommended.
- Timely interventions targeting CVRFs may prevent CVD progression and reduce mortality in pediatric CKD patients.
Background:
Cardiovascular disease (CVD) begins early in children with chronic kidney disease (CKD), and its progression is determined by the presence of single or multiple cardiovascular risk factors (CVRFs).
Objective:
To determine the prevalence of CVRFs in children with CKD and their association with mortality in children on chronic dialysis.
Methods:
This comparative cross-sectional study recruited children aged 5 - 18 years with all stages of CKD. All patients had a short history taken along with a physical examination, and their blood samples were assessed for serum creatinine, urea, albumin, calcium, phosphorus, parathyroid hormone, alkaline phosphatase, total cholesterol (TC), haemoglobin and C-reactive protein. Urine samples were also assessed for proteinuria.
Results:
One hundred and six children who met the study criteria were recruited, 34 with CKD I, 36 with CKD II - IV and 36 with CKD V (dialysis). The overall median age was 11 years (range 8 - 14), and the male/female ratio was 2.1:1. The most common CVRF was anaemia (39.6%). The rate of anaemia was higher in the dialysis group than in the CKD II - IV and CKD I groups (77.8%, 33.3% and 5.9%, respectively). Other CVRFs detected were hypertension, proteinuria, hypercholesterolaemia and dysregulated mineral bone metabolism. Seven deaths were recorded in the dialysis group during the study period. Severe hypertension and intracranial bleeding were the most common causes of death. Modifiable risk factors such as increased TC and decreased albumin levels were more common than other CVRFs in the dialysis patients who died.
Conclusions:
CVRFs may be present in early CKD, even before the decline in GFR. Routine screening for CVRFs, along with timely intervention, may prevent the progression of CVD and mortality later in life.
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