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Updated: Aug 16, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Longitudinal follow-up on vascular morphology and function in children with kidney transplants
Ebba Bergdahl1,2, Susanne Westphal Ladfors3,4, Christina Linnér1
1Pediatric Heart Center, the Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
Insights
Children with kidney transplants (KT) have higher cardiovascular risk, but it doesn't worsen over time. Pre-emptive KT is more beneficial for cardiovascular health than transplantation after dialysis.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Health
- Transplantation Medicine
Background:
- Children undergoing kidney transplants (KT) face elevated cardiovascular risks.
- Long-term cardiovascular health in pediatric KT recipients requires thorough evaluation.
Purpose of the Study:
- To assess the cardiovascular risk profile in children post-kidney transplant.
- To compare vascular parameters between kidney transplant recipients and healthy controls.
- To investigate the impact of pre-emptive transplantation versus post-dialysis transplantation on cardiovascular health.
Main Methods:
- Cardiovascular phenotyping using ultra-high-frequency ultrasound (UHFUS), pulse wave velocity (PWV), and endothelial function tests.
- Annual evaluations over three years for 42 pediatric KT recipients (ages 7.1-18).
- Comparison with 18 matched healthy controls.
Main Results:
- Children with KT exhibited higher body mass index (BMI) and blood pressure (BP) z-scores compared to controls.
- Pulse wave velocity (PWV) and carotid intima thickness (IT) were elevated in pediatric KT patients.
- Pre-emptive KT was associated with lower radial IT and dorsal pedal media thickness (MT) compared to KT after dialysis.
Conclusions:
- Pediatric kidney transplant recipients present with increased cardiovascular risk parameters that remain stable over time.
- Pre-emptive kidney transplantation appears more advantageous for preserving cardiovascular health than transplantation following dialysis.
Aim:
Our aim was to evaluate cardiovascular risk profile in 42 children with kidney transplants (KT) at the Queen Silvia Children's Hospital, Gothenburg Sweden.
Methods:
Forty-two children (7.1-18 years) with KT, time from transplantation 3.5 (0.9-13) years, were examined at inclusion and annually for three consecutive years. Eighteen matched controls were examined once. Cardiovascular phenotyping included ultra-high-frequency ultrasound (UHFUS), pulse wave velocity (PWV), and endothelial function.
Results:
Children with KT had higher body mass index (BMI) z-score and blood pressure (BP) z-score than healthy controls (BMI z-score: 0.4 ± 1.0 and - 0.2 ± 0.9, respectively, p = 0.02; SBP z-score: 0.5 ± 0.9 and - 0.8 ± 0.7; DBP z-score: 0.7 ± 0.7 and - 0.3 ± 0.5, respectively, p < 0.001). BP z-score decreased significantly over 3 years; other vascular markers remained unchanged. PWV and carotid intima thickness (IT) were higher in children with KT compared to healthy controls. Children with pre-emptive KT had lower radial IT and dorsal pedal media thickness (MT) compared to children with preceding dialysis.
Conclusion:
Children with KT show increased cardiovascular risk parameters, not increasing over time. Children on dialysis before KT have more pronounced vascular changes than those with pre-emptive KT, suggesting pre-emptive transplantation more beneficial for cardiovascular health.
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