Pediatric Nephrology

, Volume 27, Issue 9, pp 1557–1564

Intima media thickness in children undergoing dialysis

  • Luis Antonio Chavarria
  • Alejandra Aguilar-Kitsu
  • Patricia Rosas
  • Arturo Fajardo
  • Leticia Mendoza-Guevara
  • Lorena Sanchez
  • Claudia Zepeda
  • Pilar Ibarra
  • Alejandro Luna
  • Bengt Lindholm
  • Elvia García-López
Original Article

DOI: 10.1007/s00467-012-2173-1

Cite this article as:
Chavarria, L.A., Aguilar-Kitsu, A., Rosas, P. et al. Pediatr Nephrol (2012) 27: 1557. doi:10.1007/s00467-012-2173-1

Abstract

Background

Uremic vasculopathy, including vascular calcification, increases the risk for cardiovascular disease and mortality in chronic kidney disease (CKD) patients. We have investigated the prevalence and factors associated with vasculopathy in children undergoing peritoneal dialysis (PD) or hemodialysis (HD) in a single center.

Methods

Common carotid intima media thickness (cIMT) and its relation with demographics, biochemical parameters and medication was analyzed in 60 patients (mean age 12.9 ± 3.4 years; 27 girls) treated with PD (n = 31) or HD (n = 29) for 34 ± 34 months. Patients were divided into two groups: normal cIMT and increased cIMT.

Results

Mean levels of calcium, phosphate and calcium/phosphate product were in the normal range, the but parathyroid hormone level, 729 ± 670 pg/mL, was higher than the National Kidney Foundation Kidney Disease Outcome Quality Iniative (K/DOQI) recommendations. Twenty-nine patients had increased cIMT, which was associated with time on dialysis of >2 years, hypercalcemia, higher daily dose of calcitriol and HD (vs. PD). In the multivariate analysis, accounting for time on dialysis, HD persisted as a risk for increased cIMT.

Conclusions

The prevalence of increased cIMT in children on dialysis is similar to that reported in adults with CKD and increased with time on dialysis. HD was associated with increased cIMT, independently of time on dialysis; however, the results should be interpreted with caution due to the possible impact of confounding factors. These results underline the need to monitor and, if possible, prevent and treat increased cIMT in children on dialysis.

Keywords

Peritoneal dialysis Hemodialysis Hypercalcemia Hyperphosphatemia Calcitriol 

Copyright information

© IPNA 2012

Authors and Affiliations

  • Luis Antonio Chavarria
    • 1
  • Alejandra Aguilar-Kitsu
    • 1
    • 3
  • Patricia Rosas
    • 1
  • Arturo Fajardo
    • 1
  • Leticia Mendoza-Guevara
    • 1
  • Lorena Sanchez
    • 1
  • Claudia Zepeda
    • 1
  • Pilar Ibarra
    • 1
  • Alejandro Luna
    • 1
  • Bengt Lindholm
    • 2
  • Elvia García-López
    • 2
  1. 1.Departamento de Nefrologia, Hospital de Pediatria, Centro Medico Nacional “Siglo XXI”Instituto Mexicano del Seguro Social (IMSS)Mexico CityMexico
  2. 2.Divisions of Renal Medicine and Baxter Novum, CLINTECKarolinska InstitutetStockholmSweden
  3. 3.Servicio de Nefrologia, UMAE Hospital de PediatríaCentro Médico Nacional Siglo XXIMexico CityMexico

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