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Updated: Aug 27, 2025

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

16.4K

Endothelial dysfunction in children with chronic kidney disease

Juan Antonio García-Bello1, Rita A Gómez-Díaz2, Alicia Contreras-Rodríguez3

  • 1División de Investigación, Unidad Médica de Alta Especialidad Hospital de Gineco Obstetricia No. 3, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, Mexico.

Nefrologia
|September 27, 2022
PubMed

Insights

Cardiovascular disease risk factors like high triglycerides, inflammation, and low intact parathyroid hormone (iPTH) are linked to endothelial dysfunction in children with chronic kidney disease (CKD). These factors are common and treatable, offering potential interventions for CVD prevention.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Research
  • Inflammation and Immunology

Background:

  • Cardiovascular disease (CVD) is a leading cause of mortality in pediatric patients with chronic kidney disease (CKD).
  • Inflammation and endothelial dysfunction (ED) are prevalent in these children and are significant contributors to CVD.
  • Flow-mediated dilation (FMD) is a validated surrogate marker for assessing ED.

Purpose of the Study:

  • To identify risk factors associated with endothelial dysfunction (ED) in children suffering from chronic kidney disease (CKD).
  • To investigate the relationship between biochemical markers, inflammation, and ED in pediatric CKD patients.

Main Methods:

  • A cohort of 129 children aged 2-16 years with CKD was studied.
  • Clinical data and biochemical variables, including intact parathyroid hormone (iPTH), hsCRP, and triglycerides, were collected.
  • Endothelial dysfunction was assessed using flow-mediated dilation (FMD), with FMD < 7% considered abnormal.

Main Results:

  • Over half (52.7%) of the children exhibited altered FMD (< 7%).
  • Patients with abnormal FMD showed significantly higher levels of triglycerides and high-sensitivity C-reactive protein (hsCRP) compared to those with normal FMD.
  • Low iPTH levels were more frequent in children with altered FMD, and both low iPTH and elevated hsCRP were independently associated with an increased risk of ED.

Conclusions:

  • Hypertriglyceridemia, inflammation (indicated by hsCRP), and low intact parathyroid hormone (iPTH) are significantly associated with endothelial dysfunction in children with CKD.
  • These identified factors represent frequent and treatable risk factors for cardiovascular disease (CVD) in this vulnerable pediatric population.
  • Targeting these modifiable risk factors may help mitigate the progression of CVD in children with chronic kidney disease.
Abstract

Keywords:
Cardiovascular diseaseChronic kidney diseaseDilatación mediada por flujoDisfunción endotelialEndothelial dysfunctionEnfermedad cardiovascularEnfermedad renal crónicaFlow mediated dilatation

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