Dyslipidemia, carotid intima-media thickness and endothelial dysfunction in children with chronic kidney disease

Khandelwal, Priyanka; Murugan, Vijaya; Hari, Smriti; Sinha, Aditi; Hari, Pankaj; Bagga, Arvind

doi:10.1007/s00467-016-3350-4

Cited by 39 publications

(22 citation statements)

References 45 publications

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“…High‐resolution vascular ultrasound is considered a reliable screening method for assessing cardiovascular risk in children, and an increase of cIMT has been described in different pathological conditions . However, we could only find one study, performed in Iran, dealing with migraine patients .…”

Section: Discussionmentioning

confidence: 99%

“…However, results in adults may be biased by the presence of confounding factors such as smoking or other lifestylerelated complications (19). High-resolution vascular ultrasound is considered a reliable screening method for assessing cardiovascular risk in children, and an increase of cIMT has been described in different pathological conditions (20)(21)(22). However, we could only find one study, performed in Iran, dealing with migraine patients (9).…”

Section: Discussionmentioning

confidence: 99%

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A thicker intima‐media carotid wall was found in a cohort of children with recent onset migraine

et al. 2016

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We observed a significantly thicker cIMT in children with migraine compared with the controls. The brief time interval between the onset of the disease and the time of the study makes it unlikely that repetitive migraine attacks could be responsible for the thickening of the cIMT. Thus, it may be speculated that primitive vascular function abnormalities were wholly or partly responsible for the development of migraine in this paediatric cohort.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A thicker intima‐media carotid wall was found in a cohort of children with recent onset migraine

et al. 2016

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“…High density lipoprotein dysfunction is also related to the presence of hypertension, which is one of the most common sequelae of childhood CKD [152]. Indeed, endothelial dysfunction is present in children and young adults with early stage CKD, as reported based on their brachial artery flow-mediated dilatation [153], which is lower in CKD patients compared to controls [154,155]. As in adult patients, there is a link between hypertension and left ventricular hypertrophy in pediatric patients [90,[156][157][158].…”

Section: Endothelial Dysfunction and Arterial Hypertensionmentioning

confidence: 99%

“…In these children, atherosclerosis will continue to progress during life. Carotid intima media layer thickening in predialysis pediatric CKD patients has been reported in several studies [91,155,177] and, indeed, significantly correlates with lipid abnormalities and increased oxidative stress in pediatric CKD, which both are risk factors for the development of atherosclerosis [92,155]. Unlike in adults, no data of possible specific OSrelated mechanisms, responsible for atherosclerosis, are found in children and young adults with CKD.…”

Section: Atherosclerosismentioning

confidence: 99%

Oxidative stress in chronic kidney disease

et al. 2018

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Oxidative stress (OS), defined as disturbances in the pro-/antioxidant balance, is harmful to cells due to the excessive generation of highly reactive oxygen (ROS) and nitrogen (RNS) species. When the balance is not disturbed, OS has a role in physiological adaptations and signal transduction. However, an excessive amount of ROS and RNS results in the oxidation of biological molecules such as lipids, proteins, and DNA. Oxidative stress has been reported in kidney disease, due to both antioxidant depletions as well as increased ROS production. The kidney is a highly metabolic organ, rich in oxidation reactions in mitochondria, which makes it vulnerable to damage caused by OS, and several studies have shown that OS can accelerate kidney disease progression. Also, in patients at advanced stages of chronic kidney disease (CKD), increased OS is associated with complications such as hypertension, atherosclerosis, inflammation, and anemia. In this review, we aim to describe OS and its influence on CKD progression and its complications. We also discuss the potential role of various antioxidants and pharmacological agents, which may represent potential therapeutic targets to reduce OS in both pediatric and adult CKD patients.

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“…ABPM enables the diagnosis of masked HTN (HTN only occurring outside the clinical setting), isolated nocturnal HTN (elevated BP only during sleep), and a blunting of the normal nocturnal dip. ABPM is a superior tool for management of secondary HTN 12 . Isolated nocturnal HTN 13 and a blunted nocturnal dip 14 are independent predictors of CV events in hypertensive adults.…”

Section: Introductionmentioning

confidence: 99%

Nocturnal hypertension and left ventricular hypertrophy in pediatric renal transplant recipients in South India

Pais

Strologo

Iyengar

et al. 2020

Pediatric Transplantation

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HTN after renal transplantation is associated with cardiovascular morbidity. ABPM allows diagnosis of masked HTN and isolated nocturnal HTN. Longitudinal ABPM data in children post-transplant are limited. ABPM was performed in children posttransplant and repeated in 6-12 months. BP indices were used to determine the prevalence of masked HTN, masked uncontrolled HTN (masked HTN in patients on antihypertensive medications), and isolated nocturnal HTN. Linear regression determined the association between LVMI and ABPM indices. Thirty children underwent a baseline ABPM. Ambulatory HTN was present in 25 (83%). Masked HTN was present in 18 (60%) and isolated nocturnal HTN in 13 (43%). Nocturnal ambulatory BP was higher than corresponding daytime BPs (P < .001 for systolic and diastolic) and 25 (83%) had a blunted nocturnal dip. Prednisone dose predicted nocturnal DBP index and DBP load (r 2 = .40, P = .024 and r 2 = .178, P = .02). ABPM was repeated in 18patients within 11 (±3) months. BP indices decreased with time, but nocturnal BPs remained higher than daytime (P < .001 for SBP and DBP). Blunted nocturnal dip did not improve. LVH was present in 12 (57%). LVMI was directly related to the nocturnal SBP index (r 2 = .377, P = .003) and nocturnal DBP index (r 2 = .493, P < .001).We found no association between LVMI and daytime BP indices. The prevalence of masked HTN, isolated nocturnal HTN, and blunted nocturnal dip was high in children with kidney transplants. Nocturnal BP predicted LVMI. Ambulatory BP improved on longitudinal follow-up, but the pattern of isolated nocturnal HTN persisted. K E Y W O R D Sambulatory blood pressure monitoring, kidney transplant, left ventricular hypertrophy, masked hypertension, nocturnal hypertension Abbreviations: ABPM, ambulatory blood pressure monitoring; BMI, body mass index; BP, blood pressure; CNI, calcineurin inhibitor; CVD, cardiovascular disease; DBP, diastolic blood pressure; ECHO, echocardiogram; eGFR, estimate glomerular filtration rate; ESRD, end-stage renal disease; HTN, hypertension; IQR, interquartile range; LVH, left ventricular hypertrophy; LVM, left ventricular mass; LVMI, left ventricular mass index; SBP, systolic blood pressure; SD, standard deviation.

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Dyslipidemia, carotid intima-media thickness and endothelial dysfunction in children with chronic kidney disease

Abstract: Dyslipidemia was prevalent and cIMT significantly elevated in pre-dialysis pediatric CKD, indicating increased cardiovascular risk. Elevated LDL cholesterol predicted increased cIMT, strengthening the association between dyslipidemia and atherosclerosis in early CKD.

Cited by 39 publications

References 45 publications

A thicker intima‐media carotid wall was found in a cohort of children with recent onset migraine

A thicker intima‐media carotid wall was found in a cohort of children with recent onset migraine

Oxidative stress in chronic kidney disease

Nocturnal hypertension and left ventricular hypertrophy in pediatric renal transplant recipients in South India

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