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Cardiovascular alterations do exist in children with stage-2 chronic kidney disease

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Abstract

Background

Cardiovascular disease (CVD) is an important complication of chronic kidney disease (CKD) in children. However, it is not well known when and how cardiovascular alterations start.

Methods

This cross-sectional, controlled study consisted of 25 patients and 28 healthy controls. 24-h ambulatory blood pressure monitoring, aortic pulse wave velocity (aPWV), carotid intima-media thickness (cIMT) and carotid distensibility (distensibility coefficient and β stiffness index), and echocardiography were assessed to evaluate CVD. Routine biochemical parameters, fibroblast growth factor-23 (FGF23) and high sensitive C- reactive protein were measured to determine cardiovascular risk factors.

Results

Hypertension was found in 12 patients (48 %). Patients had higher FGF23 levels and aPWV-standard deviation score (SDS) as compared to the controls (p = 0.003 and p = 0.002, respectively). Aortic PWV-SDS was predicted by increased daytime systolic blood pressure load (β = 0.512, p = 0.009, R 2 = 0.262). Neither cIMT nor distensibility differed between the groups; however, older age and high level of FGF23 were independent predictors of β stiffness index in patients (β = 0.507, p = 0.005, R 2 = 0.461 and β = 0.502, p = 0.005, R 2 = 0.461, respectively). As compared to controls, patients had worse left ventricular diastolic function [lower E/A ratio p = 0.006) and increased left atrial dimension (p < 0.001)].

Conclusions

Cardiovascular deteriorations appear in children with stage-2 CKD. Good control of BP and decreasing the level of FGF23 may be useful to slow down the progression of cardiovascular complications.

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Acknowledgments

This study was sponsored by Istanbul University Scientific Research Project and a part of the data of this study was presented as a poster at the 45th annual meeting of the European Society for Pediatric Nephrology (ESPN) 2012. We thank the patients and their families taking part in this study and Dr. Mehmet Şükrü Sever and Dr. Zeynep Atam Taşdemir for their contribution.

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Authors and Affiliations

  1. Department of Pediatric Nephrology, Cerrahpaşa School of Medicine, İstanbul University, Cerrahpaşa, Kocamustafapaşa, İstanbul, 34098, Turkey

    Mehmet Taşdemir, Nur Canpolat, Ayşe Ağbaş, Meltem Dönmez Sevim, Salim Çalışkan & Lale Sever

  2. Department of Pediatric Cardiology, Cerrahpaşa School of Medicine, İstanbul University, Cerrahpaşa, Kocamustafapaşa, İstanbul, 34098, Turkey

    Ayşe Güler Eroğlu

  3. Department of Biochemistry, Cerrahpaşa School of Medicine, İstanbul University, Cerrahpaşa, Kocamustafapaşa, İstanbul, 34098, Turkey

    Dildar Konukoğlu

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  1. Mehmet Taşdemir
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  2. Ayşe Güler Eroğlu
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Correspondence to Mehmet Taşdemir.

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Taşdemir, M., Eroğlu, A.G., Canpolat, N. et al. Cardiovascular alterations do exist in children with stage-2 chronic kidney disease. Clin Exp Nephrol 20, 926–933 (2016). https://doi.org/10.1007/s10157-016-1234-3

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  • DOI: https://doi.org/10.1007/s10157-016-1234-3

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