Prevalence of Cardiovascular Disease Risk Factors in Childhood Glomerular Diseases

Abstract

Background Cardiovascular disease is a major cause of morbidity and mortality in children with chronic kidney disease. We sought to determine the prevalence of cardiovascular risk factors in children with glomerular disease and to describe current practice patterns regarding risk factor identification and management. Methods and Results Seven‐hundred sixty‐one children aged 0 to 17 years with any of 4 biopsy‐confirmed primary glomerular diseases (minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, and IgA nephropathy/vasculitis) were enrolled at a median of 16 months from glomerular disease diagnosis in the multicenter prospective Cure Glomerulonephropathy Network study. Prevalence of traditional (hypertension, hypercholesterolemia, and obesity) and novel (proteinuria, prematurity, and passive smoke exposure) cardiovascular risk factors were determined at enrollment and compared across glomerular disease subtypes. Frequency of screening for dyslipidemia and prescribing of lipid‐lowering or antihypertensive medications were compared across glomerular disease subtype, steroid exposure, and remission status groups. Compared with the general population, all traditional risk factors were more frequent: among those screened, 21% had hypertension, 51% were overweight or obese, and 71% had dyslipidemia. Children who were not in remission at enrollment were more likely to have hypertension and hypercholesterolemia. Fourteen percent of hypertensive children were not receiving antihypertensives. Only 49% underwent screening for dyslipidemia and only 9% of those with confirmed dyslipidemia received lipid‐lowering medications. Conclusions Children with primary glomerular diseases exhibit a high frequency of modifiable cardiovascular risk factors, particularly untreated dyslipidemia. Lipid panels should be routinely measured to better define the burden of dyslipidemia in this population. Current approaches to screening for and treating cardiovascular risk factors are not uniform, highlighting a need for evidence‐based, disease‐specific guidelines.

Hypolipidemic and antioxidant effects of the juice and water seed extracts of two pomegranate species in high-cholesterol diet fed rats

“…Cardiovascular disorders (CVDs) remain the leading cause of death worldwide, with very high incidence and mortality rates (Ashoor et al, 2019). Oxidative stress is known to be a key player in the development of coronary heart disease and has been well described as the mechanism driving a range of health conditions, such as hypertension, dyslipidemia, metabolic syndrome, diabetes mellitus, and obesity (Pignatelli et al, 2018).…”

Utility of non-HDL-C in predicting proteinuria remission of idiopathic membranous nephropathy: a retrospective cohort study

“…However, the lipid alterations in different renal pathological types might differ. Hypercholesterolemia was the most frequent complication in IMN (82%) among four common primary glomerular diseases including membranous nephropathy, IgA nephropathy, minimal change disease and FSGS [ 10 ]. In addition, our result indicated non-HDL-C as the most relevant marker among other markers in the lipid profile with proteinuria in IMN.…”

“…The linkage between hypercholesterolemia and outcomes of primary glomerular diseases has been reported [ 10 ]. In a multicenter cohort study involving 761 children, 72% of participants not in remission had hypercholesterolemia than 43% of those in remission ( P < 0.001), indicating an association between hypercholesterolemia and not achieving remission [ 10 ]. The effect of lipid profile parameters on IMN has been rarely studied.…”

Association of Obesity with Cardiovascular Risk Factors and Kidney Disease Outcomes in Primary Proteinuric Glomerulopathies

“…Another single-center study found that BMI was not related to progression of kidney disease [16]. Further, although the prevalence of obesity in patients with glomerular disease has been reported in a handful of studies [17][18][19], the association between obesity and cardiovascular risk profile has not been previously described.…”