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Updated: Feb 14, 2026
Author Spotlight: Assessing the Cardiovascular Profile of Patients with Metabolic Syndrome
Published on: September 27, 2024
Increased carotid intima-media thickness in African American pediatric kidney transplant recipients
Kristen Sgambat1, Sarah Clauss2, K Y Lei3
1Department of Nephrology, Children's National Health System, Washington, DC, USA.
Insights
African American kidney transplant recipients show higher carotid intima-media thickness (CIMT), indicating increased cardiovascular risk. Metabolic syndrome particularly impacts CIMT in these young patients.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Health
- Transplant Medicine
Background:
- Subclinical cardiovascular dysfunction, detectable by carotid intima-media thickness (CIMT) ultrasound, is a concern in kidney transplant recipients.
- African Americans (A-A) face a higher risk of cardiovascular disease, yet CIMT in A-A pediatric kidney transplant recipients remains understudied.
Purpose of the Study:
- To investigate the determinants of CIMT in a multiracial pediatric kidney transplant population.
- To specifically examine CIMT in African American (A-A) pediatric kidney transplant recipients and compare it to non-A-A recipients and healthy controls.
Main Methods:
- A prospective, controlled, longitudinal study involving 42 pediatric kidney transplant recipients and 24 healthy children (14 A-A).
- Measurements included Body Mass Index (BMI), waist-to-height ratio, fasting glucose, lipid panel, HbA1c%, and CIMT at 1, 18, and 30 months post-transplant.
Main Results:
- A-A transplant recipients exhibited higher CIMT (0.49 mm) compared to non-A-A recipients (0.44 mm) and A-A controls (0.47 mm) across all time points.
- Pre-transplant hyperparathyroidism predicted high CIMT-for-race, and A-A race was linked to 10% higher CIMT.
- Metabolic syndrome increased CIMT by 0.03 mm specifically in A-A transplant recipients.
Conclusions:
- African American pediatric kidney transplant recipients demonstrate elevated CIMT, suggesting increased subclinical cardiovascular damage.
- Metabolic syndrome disproportionately exacerbates CIMT in A-A children post-transplant.
- CIMT measurement offers a valuable tool for early detection of cardiovascular risk in this vulnerable pediatric population.
Abstract:
Early signs of subclinical CV dysfunction can be detected by ultrasound for CIMT. Although A-A are at high risk for CV disease, CIMT of A-A kidney transplant recipients has not been previously investigated. The aim of this prospective, controlled, longitudinal study was to investigate determinants of CIMT in a multiracial pediatric kidney transplant population, with a focus on A-A. Transplant recipients (n = 42) had BMI, waist-to-height ratio, fasting glucose, lipid panel, HbA1c%, and CIMT measured at 1, 18, and 30 months post-transplant. Twenty-four healthy children (14 A-A) served as controls. CIMT of A-A transplant (0.49, 0.49, and 0.48 mm) was higher than non-AA transplant (0.43, 0.44, and 0.44 mm) at 1, 18, and 30 months and higher than A-A controls (0.47 mm). Hyperparathyroidism prior to transplant predicted high CIMT-for-race. A-A race was associated with 10% higher CIMT vs non-A-A transplant. Metabolic syndrome was associated with 0.03 ± 0.01 mm increase in CIMT among A-A transplant recipients only. In conclusion, A-A kidney transplant recipients have increased CIMT. Metabolic syndrome disproportionately affects CIMT of A-A children post-transplant. Identification of subclinical CV damage, detected by CIMT, may provide an opportunity for early detection of CV risk in this vulnerable population.
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