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Cardiovascular disease as a late complication of end-stage renal disease in children

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Abstract

As in older adults, cardiovascular disease is the most important cause of death in adolescents and young adult patients with end-stage renal disease (ESRD) since childhood. This concerns patients on dialysis as well as transplant patients, despite the fact that a long duration of dialysis during childhood is an extra mortality risk factor. Left ventricular hypertrophy (LVH), aortic valve calcification, and increased arterial stiffness, but not increased arterial intima media thickening, are the most frequently observed alterations in young adult survivors with childhood ESRD. In transplanted patients a concentric LVH as a result of chronic hypertension is mostly observed; in dialysis patients a more asymmetric septal LVH is found as a result of chronic volume overload. These results suggest that in children and young adults with ESRD chronic pressure and volume overload, a high calcium-phosphate product, and chronic inflammation, but not dyslipidemia, play a role in the development of cardiovascular disease.

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Authors and Affiliations

  1. Emma Children’s Hospital AMC, Amsterdam , The Netherlands

    Jaap W. Groothoff & Jean Claude Davin

  2. Wilhelmina Children’s Hospital, Utrecht, The Netherlands

    Marc R. Lilien

  3. University Medical Center St. Radboud, Nijmegen, The Netherlands

    Nicole C. A. J. van de Kar

  4. Sophia Children’s Hospital, Rotterdam, The Netherlands

    Eric D. Wolff

  5. Department of Pediatric Nephrology, Emma Children’s Hospital AMC, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands

    Jaap W. Groothoff

Authors
  1. Jaap W. Groothoff
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  2. Marc R. Lilien
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  3. Nicole C. A. J. van de Kar
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  4. Eric D. Wolff
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  5. Jean Claude Davin
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Corresponding author

Correspondence to Jaap W. Groothoff.

Additional information

This work was presented in part at the IPNA Seventh Symposium on Growth and Development in Children with Chronic Kidney Disease: The Molecular Basis of Skeletal Growth, 1–3 April 2004, Heidelberg, Germany

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Groothoff, J.W., Lilien, M.R., van de Kar, N.C.A.J. et al. Cardiovascular disease as a late complication of end-stage renal disease in children. Pediatr Nephrol 20, 374–379 (2005). https://doi.org/10.1007/s00467-004-1624-8

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  • DOI: https://doi.org/10.1007/s00467-004-1624-8

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