A comprehensive study of cardiovascular risk factors, cardiac function and vascular disease in children with chronic renal failure

作者：Rinat Choni^*; Becker Cohen Rachel; Nir Amiram; Feinstein Sofia; Shemesh David; Algur Nurit; Ben Shalom Efrat; Farber Benjamin; Frishberg Yaacov

来源：Nephrology Dialysis Transplantation, 2010, 25(3): 785-793.

DOI：10.1093/ndt/gfp570

• arterial stiffening
• CVS risk factors
• myocardial dysfunction
• renal failure
• uric acid

Methods. We assessed 70 patients, aged 4 months to 18 years, with chronic kidney disease stages 3-5, for known risk factors of cardiovascular disease and for additional laboratory and clinical variables which may have an impact on this disease process. Carotid artery ultrasound was used to evaluate vascular structure and function, whereas myocardial disease was assessed by echocardiography.
Results. Traditional risk factors, although present in this cohort, did not accumulate with progression of chronic kidney disease. Non-traditional risk factors increased in number and severity in correlation with the stage of CKD. The main myocardial abnormalities were left ventricular hypertrophy and diastolic dysfunction. Vascular function tests correlated with calcium-phosphate metabolism variables, homocysteine and time-averaged serum uric acid.
Conclusions. This study shows that children with CKD are exposed to risk factors and demonstrate signs of cardiovascular disease already at a young age. The possible role of uric acid and homocysteine in the evolution of cardiovascular disease is discussed. Further studies looking at possible interventions to prevent cardiovascular morbidity and mortality in this high risk population are needed.

• 出版日期2010-3