Cardiovascular mortality in children and young adults with end-stage kidney disease

Parekh, Rulan S.; Carroll, Caitlin; Wolfe, Robert A.; Port, Friedrich K.

doi:10.1067/mpd.2002.125910

Cited by 411 publications

(293 citation statements)

References 19 publications

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“…Analysing the USRDS database, Parekh et al reported that 311 of the 1,380 (22.5%) deaths in patients aged 0-30 years who had undergone dialysis between 1990 and 1996 were from a cardiac cause [60]. Similarly, ANZDATA [3], the Dutch cohort [4], and German [11] and Polish [61] single-centre studies reported cardiovascular disease as the single most common cause of death in their CKD patients.…”

Section: Cardiovascular Risk Factorsmentioning

confidence: 99%

“…Chronic volume overload is the most important factor contributing to uncontrolled hypertension in the dialysis population [60], with significantly higher BP in HD patients than in PD patients reported in all series [60,78,[86][87][88]. A single 'office' BP may underestimate the true prevalence of hypertension, and ambulatory BP monitoring is increasingly used to diagnose and manage hypertension in dialysis patients [88][89][90].…”

Section: Fluid Overload and Hypertensionmentioning

confidence: 99%

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Long-term outcome of chronic dialysis in children

et al. 2005

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As the prevalence of children on renal replacement therapy (RRT) increases world wide and such therapy comprises at least 2% of any national dialysis or transplant programme, it is essential that paediatric nephrologists are able to advise families on the possible outcome for their child on dialysis. Most children start dialysis with the expectation that successful renal transplantation is an achievable goal and will provide the best survival and quality of life.

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Section: Cardiovascular Risk Factorsmentioning

confidence: 99%

Section: Fluid Overload and Hypertensionmentioning

confidence: 99%

Long-term outcome of chronic dialysis in children

et al. 2005

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“…These structural abnormalities include LV hypertrophy, LV dilation, and impaired systolic function, and each is strongly linked to a poor cardiovascular prognosis (1)(2)(3)(4)(5)(6). Although heart failure and sudden cardiac death are common in CKD, the appropriate management of myocardial disease is not fully understood (7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Advanced Parameters of Cardiac Mechanics in Children with CKD

Chinali

Matteucci²,

Franceschini

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives Newer parameters of cardiac mechanics provide additional insights on cardiac dysfunction in adult patients with CKD. The aim of this study was to identify prevalence of subclinical abnormalities in cardiac function through the analysis of novel indices of cardiac mechanics in a large population of children with CKD.Design, setting, participants, & measurements Between 2009 and 2011, the prospective observational Cardiovascular Comorbidity in Children with CKD Study enrolled patients with CKD ages 6-17 years old with eGFR=10-45 ml/min per 1.73 m 2 in 14 European countries. Cardiac morphology and function were assessed through echocardiography. The analysis presented encompasses global radial, longitudinal, and circumferential strains as well as time to peak analysis. Data were compared with 61 healthy children with comparable age and sex.Results Data on 272 patients with CKD with complete echocardiographic assessment are reported (age =12.863.5 years old; 65% boys). Patients with CKD showed mildly higher office BP values and higher prevalence of left ventricular hypertrophy, but no differences were observed among groups in left ventricular ejection fraction. Strain analysis showed significantly lower global radial strain (29.6%613.3% versus 35.5%68.9%) and circumferential strain components (221.8%64.8% versus 228.2%65.0%; both P,0.05) in patients with CKD without significant differences observed in longitudinal strain (215.9%63.4% versus 216.2%63.7%). Lower values of global radial strain were associated with lower circumferential endocardial-to-epicardial gradient (r=0.51; P,0.01). This association remained significant after adjusting for BP, eGFR, and presence of left ventricular hypertrophy. Eventually, patients with CKD also showed higher delay in time to peak cardiac contraction (58628 versus 37618 milliseconds; P,0.05).Conclusions A significant proportion of children with CKD show impaired systolic mechanics. Impaired systolic function is characterized by lower radial strain, transmural circumferential gradient, and mild cardiac dyssynchrony. This study suggests that analysis of cardiac strain is feasible in a large multicenter study in children with CKD and provides additional information on cardiac pathophysiology of this high-risk population.

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“…Although the risk of cardiovascular mortality decreases significantly after transplantation, it continues to account for about 10% of all deaths in the post-transplant period (27). Among the many contributors to post-transplant cardiovascular mortality, is dyslipidemia.…”

Section: Discussionmentioning

confidence: 99%

Unusual Pattern of Dyslipidemia in Children Receiving Steroid Minimization Immunosuppression after Renal Transplantation

Lau

Tancredi

Perez

et al. 2010

Clinical Journal of the American Society of Nephrology

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Results: Twenty-nine patients were studied. Sixteen were receiving maintenance steroids, and 13 were on a steroid minimization regimen. Mixed effects analysis of covariance models demonstrated that at 1 month, children receiving maintenance steroids had higher cholesterol compared with the steroid minimization group. Statistically significant differences in total cholesterol were not seen at other time points. Similar findings were noted for the LDL cholesterol, LDL/HDL, and cholesterol/HDL ratios. At 1 month, the serum HDL cholesterol was substantially lower in the steroid minimization group. Differences in the HDL cholesterol levels remained significant throughout the first year.Conclusions: Steroid use is a significant independent risk factor for hypercholesterolemia during the first post-transplant month. The significance of lower HDL cholesterol among patients receiving steroid minimization needs further study and may be cause for concern.

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Cardiovascular mortality in children and young adults with end-stage kidney disease

Cited by 411 publications

References 19 publications

Long-term outcome of chronic dialysis in children

Long-term outcome of chronic dialysis in children

Advanced Parameters of Cardiac Mechanics in Children with CKD

Unusual Pattern of Dyslipidemia in Children Receiving Steroid Minimization Immunosuppression after Renal Transplantation

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