在患有CKD的儿童中,代谢酸和心血管疾病风险
Denver D Brown1, Jennifer Roem2, Kimberly Reidy3
1Division of Nephrology, Children's National Hospital/Department of Pediatrics, George Washington School of Medicine, Washington, DC.
Kidney360
|July 23, 2025
概括
患有慢性病 (CKD) 的儿童的代谢酸 (MA) 与血压升高和左心室质量增加有关,这表明心血管疾病 (CVD) 风险升高. 进一步的研究应该探索疗法以减轻这些风险.
科学领域:
- 儿科脏病学 儿科脏病学
- 心血管研究研究心血管研究
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 代谢性酸化 (MA) 在患有慢性病 (CKD) 的儿童中很常见.
- 在成人中,MA和心血管疾病 (CVD) 结局之间的关联已确立,但在儿科CKD中未得到充分研究.
- 血清二碳酸盐水平作为MA的替代标志物.
研究的目的:
- 评估血清二碳酸盐 (MA) 低水平与患有CKD的儿童中不良心血管疾病风险之间的关联.
- 分析血清二碳酸盐,血压 (BP) 和左心室质量指数 (LVMI) 之间的关系.
主要方法:
- 在CKiD研究中利用了936名儿童 (年龄≥1岁) 的数据,每1.73m2.2的eGFR为30-90毫升/分钟.
- 采用线性回归模型来评估时间变化的血清二碳酸盐,静止血压,门诊血压监测 (ABPM) 和LVMI之间的关联.
- 调整为人口和临床共变量,为年龄/性别/身高比较索引BP.
主要成果:
- 在完全调整的模型中,较低的血清二碳酸盐与较高的静止血压有关.
- 在较低的血清二碳酸盐和较低的ABPM缩指数 (清醒和睡眠) 之间发现了显著的关联.
- 在较低的血清二碳酸盐水平下观察到LVMI (0.02) 的小但显著增加.
结论:
- 儿科CKD中的MA与休息时血压升高,ABPM降低和LVMI增加有关.
- 未来的研究应该调查MA和CVD风险跨CKD严重程度,结合先进的CVD标志物.
- 需要进行临床试验,以确定性疗法是否可以降低这种人群中的心血管疾病风险.
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