Disturbances of lipid metabolism in children with chronic renal failure

Querfeld, Uwe

doi:10.1007/bf01213345

Cited by 44 publications

(32 citation statements)

References 85 publications

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“…Disturbances of lipid metabolism in children with chronic renal failure had been reviewed by Querfeld in 1993 [4]. He reported that uremic dyslipidemia characterised by high TGD and low HDL-C serum levels was present in the majority of patients whereas levels of TC, LDL-C and VLDL-C were frequently elevated.…”

Section: Discussionmentioning

confidence: 99%

“…Dyslipidemias are disorders of lipoprotein metabolism that result in excess total cholesterol (TC), excess low-density lipoprotein cholesterol (LDL-C), excess triglyceride (TGD), or deficiency of high-density lipoprotein cholesterol (HDL-C). Dyslipidemia patterns similar to familial hypertriglyceridemia or type IV hyperlipidemia were found to be common in pediatric patients undergoing chronic dialysis treatment [1][2][3][4]. There are many factors which may contribute to the risk of dyslipidemia in chronic dialysis patients, such as a diet rich in fat and carbohydrates [1], medications [5], use of high molecular weight heparin [6], decrease in lipoprotein lipase level [1], high glucose content of dialysate [7] and L-carnitine deficiency [1].…”

Section: Introductionmentioning

confidence: 99%

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Dyslipidemia among Sudanese Children Undergoing Maintenance Dialysis

Ali¹,

Am²

2010

Arab J. Nephr. Trans

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Introduction: Dyslipidemia is an established risk factor for atherosclerosis and cardiovascular disease. It is common among children undergoing maintenance dialysis. To our knowledge, this is the first report on the lipid profile of children undergoing maintenance hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD) in Sudan. Methods:We studied 17 children on HD, 11 children on CAPD and 28 controls. The levels of total cholesterol (TC), triglycerides (TGD) and high density lipoprotein cholesterol (HDL-C) were measured from fasting serum samples using electrophoresis and low density lipoprotein cholesterol (LDL-C) was then calculated.Results: End stage renal failure (ESRF) children had higher mean TC (193±36 versus 135±17 mg/dl), higher mean TGD (120±38 versus 90±15 mg/dl), higher mean LDL-C (129±32 versus 69±18 mg/dl), and lower mean HDL-C (39±12 versus 49±4 mg/dl) than controls (P=0.00 for all parameters). CAPD patients had higher mean TC (211±39 versus 181±30 mg/dl) and higher LDL-C (145±35 versus 118±25 mg/dl) than controls (P=0.03 for both parameters). The prevalence of dyslipidemia among ESRF patients was 75% while none of the control group had lipid parameters outside the accepted range. Among ESRF patients, 39.3% had TC > 200 mg/dl, 21.4% had TGD > 150 mg/dl, 42.9% had LDL-C > 130 mg/dl, and 35.7% had HDL-C < 35 mg/dl. Abnormal HDL-C values were more prevalent among CAPD patients compared to HD patients (52.9% versus 9.1%, P=0.02) Conclusion:Despite the small number of studied children, this study is likely to reflect the high prevalence of dyslipidemia among children undergoing maintenance dialysis treatment in Sudan.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dyslipidemia among Sudanese Children Undergoing Maintenance Dialysis

Ali¹,

Am²

2010

Arab J. Nephr. Trans

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“…The pattern of hyperlipidemia is known to be different in uremic children according to the mode of renal replacement therapy before transplantation and, after transplantation, the pattern of hyperlipidemia rapidly changes during the first few months [4]. It has been shown in the adult population that, regardless of the type of hyperlipidemia prior to renal transplantation, the serum lipid pattern converges to a new, common pattern of "post-transplant hyperlipidemia" [3,5].…”

Section: Introductionmentioning

confidence: 99%

Serum lipid pattern unifies following renal transplantation in children

Muller

Koeppe

Arbeiter

et al. 2003

Pediatric Nephrology

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Hyperlipidemia is a common problem in solid organ transplant recipients. In this study we evaluated the role of pre-transplant renal replacement therapy on early and late changes of serum lipid levels in children following renal transplantation. In 46 children with chronic renal failure (median age 10.3 years) and 12 children with heart failure (median age 5.0 years), cholesterol and triglycerides were measured before and during follow-up after transplantation. Children with renal failure had significantly higher serum lipids than controls ( n=34, median age 9.2 years) and patients with heart failure. Pre transplantation, cholesterol and triglycerides were significantly lower in the hemodialysis than in the peritoneal dialysis population, whereas conservatively treated children had intermediate levels. After transplantation, serum cholesterol converged towards a mean level of 208 mg/dl and triglyceride levels converged towards a uniform level of 195 mg/dl at 9 months post transplant. The ratio of cholesterol/high-density lipoprotein significantly decreased from 4.7 to 3.8. The pattern of "post-transplant hyperlipidemia" was similar in both renal and cardiac allograft recipients. Hence, the early post-transplant changes of serum lipid pattern are markedly dependent on the mode of pre-transplant renal replacement therapy. Later, serum lipid levels were no longer influenced by prior renal replacement therapy and showed a new pattern of "post-transplant hyperlipidemia" in all children.

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“…The data are more alarming for young CKD patients, as CVD-specific mortality rates in children and young adults with ESRD have increased over the last two decades (3) and are approximately 1000 times higher than in comparably aged populations without CKD (4). It is likely that the coexistence of highly prevalent traditional (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) and uremia-related (16 -19) cardiovascular risk factors (CVRF) contribute to this population's unique susceptibility to CVD.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Correlates of Multiple Cardiovascular Risk Factors in Children with Chronic Kidney Disease

Wilson

Schneider

Cox

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Although prevalence of traditional cardiovascular risk factors (CVRF) has been described in children with CKD, the frequency with which these CVRF occur concomitantly and the clinical characteristics associated with multiple CVRF are unknown. This study determined the prevalence and characteristics of multiple CVRF in children in the Chronic Kidney Disease in Children study.Design, setting, participants, & measurements Using cross-sectional data from first follow-up visits, we determined the prevalence of four CVRF: hypertension (casual BP Ͼ95 th percentile or self-reported hypertension with concurrent use of anti-hypertensive medication), dyslipidemia (triglycerides Ͼ130 mg/dl, HDL Ͻ40 mg/dl, non-HDL Ͼ160 mg/dl, or use of lipid-lowering medication), obesity (BMI Ͼ95 th percentile), and abnormal glucose metabolism (fasting glucose Ͼ110 mg/dl, insulin Ͼ20 IU/ml, or HOMA-IR Ͼ2.20, Ͼ3.61, or Ͼ3.64 for those at Tanner stage 1, 2 to 3, or 4 to 5, respectively) in 250 children (median age 12.2 years, 74% Caucasian, median iohexol-based GFR 45.2 ml/min per 1.73 m 2 ).Results Forty-six percent had hypertension, 44% had dyslipidemia, 15% were obese, and 21% had abnormal glucose metabolism. Thirty-nine percent, 22%, and 13% had one, two, and three or more CVRF, respectively. In multivariate ordinal logistic regression analysis, glomerular disease and nephrotic-range proteinuria were associated with 1.96 (95% confidence interval, 1.04 to 3.72) and 2.04 (95% confidence interval, 0.94 to 4.43) higher odds of having more CVRF, respectively. ConclusionsWe found high prevalence of multiple CVRF in children with mild to moderate CKD. Children with glomerular disease may be at higher risk for future cardiovascular events.

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Disturbances of lipid metabolism in children with chronic renal failure

Cited by 44 publications

References 85 publications

Dyslipidemia among Sudanese Children Undergoing Maintenance Dialysis

Dyslipidemia among Sudanese Children Undergoing Maintenance Dialysis

Serum lipid pattern unifies following renal transplantation in children

Prevalence and Correlates of Multiple Cardiovascular Risk Factors in Children with Chronic Kidney Disease

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