Cardiovascular risk in children and adolescents with end stage renal disease

Author(s):Show less -

do Val, Maria Luiza ^[1] ; Menezes, Fernanda Souza ^[1] ; Massaoka, Henrique Tsuha ^[2] ; Scavarda, Valeska Tavares ^[3] ; Czapkowski, Adriano ^[4] ; Leite, Heitor Pons ^[1] ; Moises, Valdir Ambrosio ^[3] ; Ajzen, Sergio Aron ^[4] ; de Abreu Carvalhaes, Joao Tomas ^[1] ; Medina Pestana, Jose Osmar ^[5] ; Koch-Nogueira, Paulo ^[1]

Affiliation

^[1] Univ Fed Sao Paulo UNIFESP, Dept Pediat, Sao Paulo, SP - Brazil

^[2] Univ Fed Sao Paulo UNIFESP, Sao Paulo, SP - Brazil

^[3] Univ Fed Sao Paulo UNIFESP, Dept Cardiol, Sao Paulo, SP - Brazil

^[4] Univ Fed Sao Paulo UNIFESP, Dept Radiol, Sao Paulo, SP - Brazil

^[5] Univ Fed Sao Paulo UNIFESP, Dept Nefrol, Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: Clinics; v. 74, 2019.
• Web of Science Citations: 0

Abstract

OBJECTIVES: To evaluate cardiovascular involvement in children and adolescents with End Stage Renal Disease (ESRD) and to characterize the main risk factors associated with this outcome. METHODS: Cross-sectional study of 69 children and adolescents at renal transplantation and 33 healthy individuals matched by age and gender. The study outcomes were left ventricular mass z-score (LVMZ) and carotid artery intima-media thickness (CIMT). The potential risk factors considered were age, gender, CKD etiology, use of oral vitamin D and calcium-based phosphate binders, systolic and diastolic blood pressure, body mass index z-score, time since diagnosis, dialysis duration, serum levels of ionic calcium, phosphorus, parathyroid hormone, fibroblast growth factor (FGF 23), uric acid, homocysteine, cholesterol, triglycerides, C-reactive protein (CRP), vitamin D and hemoglobin. RESULTS: In the multivariate analysis, the factors associated with LVMZ were dialysis duration, age, systolic blood pressure, serum hemoglobin and HDL cholesterol levels. Regarding CIMT, in the multivariate analysis, systolic blood pressure was the only factor associated with the outcome. CONCLUSION: Children exhibited important cardiovascular involvement at the time of the renal transplantation. Both of the studied outcomes were independently associated with systolic blood pressure. For this reason, controlling blood pressure seems to be the main therapy to minimize cardiovascular involvement in children with ESRD. (AU)

• FAPESP's process: 11/24030-0 - Frequency and risk factors for arteriopathy in children and adolescents with end stage renal disease
• Grantee: Paulo Cesar Koch Nogueira
• Support Opportunities: Regular Research Grants