Cardiovascular risk factors in children on dialysis: an update

Querfeld, Uwe; Schaefer, Franz

doi:10.1007/s00467-018-4125-x

Cited by 21 publications

(20 citation statements)

References 141 publications

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“…However, use of adult mice might have introduced another potential confounder, i.e., loss of bone with aging (48) that generally occurs after 6 months and that might have accentuated extraskeletal bone mineralization. Irrespective of these considerations, vascular calcification has been recognized as an important consequence of CKD in both children (18) and adults, i.e., in the presence of both growing and resorbing skeletons, and the underlying pathophysiology at both life stages may be similar. However, further studies are needed to carefully examine these issues.…”

Section: Discussionmentioning

confidence: 99%

“…Circulating concentrations of calcification inhibitors, such as fetuin-A and osteoprotegerin (OPG), and promoters, such as phosphorus, may contribute to modulating the extraskeletal calcification that occurs in CKD (18). However, site-specific transdifferentiation of muscle cells to osteogenic cells has also been described as contributing to extravascular calcification.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Vitamin D–regulated osteocytic sclerostin and BMP2 modulate uremic extraskeletal calcification

Nguyen-Yamamoto¹,

Tanaka²,

St‐Arnaud³

et al. 2019

JCI Insight

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Vitamin D–regulated osteocytic sclerostin and BMP2 modulate uremic extraskeletal calcification

Nguyen-Yamamoto¹,

Tanaka²,

St‐Arnaud³

et al. 2019

JCI Insight

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“…Cardiovascular disease is an independent and life‐threatening risk factor in every stage of CKD, even after RTx . LVH is generally recognized as a risk factor for cardiovascular disease .…”

Section: Introductionmentioning

confidence: 99%

Changes in cardiac function after renal transplantation in children: Significance of pre‐transplantation left ventricular hypertrophy

Masuda

Hamasaki

Kubota

et al. 2019

Pediatric Transplantation

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LVH is a significant risk factor for the development of cardiovascular morbidity. However, few studies have evaluated the changes in cardiac function that occur in pediatric patients with ESRD undergoing RTx. Therefore, we assessed the changes in parameters associated with LVH in children within the first year after RTx. We retrospectively evaluated patients aged < 18 years who underwent initial RTx from April 2014 to December 2016. The patients were divided into 2 groups according to the presence of LVH before RTx. Clinical, biochemical, and echocardiographic parameters including the LVMI before and 1 year after RTx were evaluated in both groups. Twenty‐six patients were included in this study. Seven of the 26 patients had LVH before RTx. Among the echocardiographic parameters, the LVMI was significantly improved 1 year after RTx in the initial LVH group (57.79 ± 11.86 vs 42.20 ± 6.03 g/cm2.7, P = .018), while no change was observed in the initial non‐LVH group (32.66 ± 7.52 vs 35.17 ± 12.86 g/cm2.7, P = .376). Improvement of the ejection fraction was also observed only in the initial LVH group (66.5% ± 5.3% vs 72.2% ± 5.2%, P = .042). Children who had LVH before RTx showed significant improvements in the LVMI and ejection fraction even within 1 year after RTx. To minimize aggravation of cardiac function, early RTx should be considered for patients with LVH.

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“…Several cross‐sectional studies, usually investigating children with various stages of CKD including dialysis, have detected a remarkably similar assembly of risk factors associated with surrogate measurements. These include hypertension, dyslipidaemia, disturbances of mineral metabolism and treatment with active vitamin D preparations, anaemia, and in dialysis patients, the duration of dialysis treatment 13 …”

Section: Risk Factorsmentioning

confidence: 99%

“…Unfortunately, registry data as well as many single centre studies have shown that treatment with haemodialysis or peritoneal dialysis aggravates pre‐existing risk factors and accelerates the progression of CVD with additional dialysis‐related risk factors (Figure 1), such as salt and fluid overload, intradialytic hypotension, impaired cardiac mechanics, oxidative stress and protein modification. Vascular calcifications were shown to increase with time on dialysis 13 . To overcome the limitations of conventional haemodialysis, various paediatric centres have developed intensified haemodialysis programs in the form of short daily (SDHD), nocturnal intermittent (NIHD, in centre), daily home (DHHD) or daily nocturnal home HD (NHHD).…”

Section: Lessons Learned From Children With Ckdmentioning

confidence: 99%

Cardiovascular disease in childhood and adolescence: Lessons from children with chronic kidney disease

Querfeld

2020

Acta Paediatrica

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Children suffering from chronic kidney disease (CKD) have the apparent highest risk for the development of cardiovascular disease (CVD) at a young age. While symptoms of CVD are characteristically absent in childhood and adolescence, remodelling of the myocardium, medium and large‐sized arteries and of the microcirculation is clinically significant and can be assessed with non‐invasive technology. Kidney disease and its progression are the driver of CVD, mediated by an unparalleled accumulation of risk factors converging on several comorbid conditions including hypertension, anaemia, dyslipidaemia, disturbed mineral metabolism and chronic persistent inflammation. Large prospective paediatric cohorts studies have provided valuable insights into the pathogenesis and the progression of CKD‐induced cardiovascular comorbidity and have characterised the cardiovascular phenotype in young patients. They have also provided the rationale for close monitoring of risk factors and have defined therapeutic targets. Recently discovered new biomarkers could help identify the individual risk for CVD. Prevention of CVD by aggressive therapy of modifiable risk factors is essential to enable long‐term survival of young patients with CKD.

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Cardiovascular risk factors in children on dialysis: an update

Cited by 21 publications

References 141 publications

Vitamin D–regulated osteocytic sclerostin and BMP2 modulate uremic extraskeletal calcification

Vitamin D–regulated osteocytic sclerostin and BMP2 modulate uremic extraskeletal calcification

Changes in cardiac function after renal transplantation in children: Significance of pre‐transplantation left ventricular hypertrophy

Cardiovascular disease in childhood and adolescence: Lessons from children with chronic kidney disease

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