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Cardiovascular risk factors in children on dialysis: an update

Uwe Querfeld1, Franz Schaefer2

  • 1Department of Pediatrics, Division of Gastroenterology, Nephrology and Metabolic Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany. Uwe.querfeld@charite.de.

Pediatric Nephrology (Berlin, Germany)
|November 2, 2018
PubMed

Insights

Cardiovascular disease (CVD) is a serious complication for children with chronic kidney disease (CKD). Early detection of CVD markers and managing risk factors are crucial for improving outcomes in these young patients.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Research
  • Medical Imaging

Background:

  • Cardiovascular disease (CVD) is a significant comorbidity in pediatric chronic kidney disease (CKD).
  • Early CVD indicators like increased left ventricular mass and carotid intima-media thickness are observed even in young children with CKD.
  • Vascular calcifications are hallmarks of advanced CVD, primarily in adolescents and young adults on dialysis.

Purpose of the Study:

  • To investigate the progression and risk factors of cardiovascular disease in children with chronic kidney disease.
  • To understand the impact of dialysis on the acceleration of CVD in pediatric CKD patients.
  • To identify key mechanisms underlying CKD-induced cardiovascular damage.

Main Methods:

  • Utilized association studies with surrogate CVD parameters to identify risk factors.
  • Analyzed imaging studies to assess early phenotypic characteristics of CVD.
  • Examined the time-dependent accumulation of coronary artery calcifications in pediatric CKD patients on dialysis.

Main Results:

  • Identified numerous risk factors contributing to CVD in pediatric CKD.
  • Demonstrated that dialysis exacerbates pre-existing risks and introduces new dialysis-related factors.
  • Observed a time-dependent accumulation of coronary artery calcifications in children and young adults on dialysis.

Conclusions:

  • Understanding risk factors improves comprehension of CKD-induced cardiovascular damage.
  • Treatment strategies involve risk factor assessment, optimization of modifiable factors, and considering intensified hemodialysis or transplantation.
  • Early identification and management of CVD are critical for pediatric CKD patients.

Keywords:
Cardiovascular diseaseChildrenDialysis vintageIntensified dialysisRisk factorsVascular calcification

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