Dyslipidemia in children with chronic kidney disease

Saland, Jeffrey M.; Pierce, Christopher B.; Mitsnefes, Mark; Flynn, Joseph T.; Goebel, Jens; Kupferman, Juan C.; Warady, Bradley A.; Furth, Susan L.

doi:10.1038/ki.2010.311

Cited by 101 publications

(58 citation statements)

References 53 publications

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“…17,18 In terms of other traditional risk factors, dyslipidemia was found in 45% and obesity in15% of the CKiD cohort. 19,20 As mentioned earlier, although diabetes is very rare cause of CKD in children, hyperinsulinemia and insulin resistance are present in 9% and 19%, respectively, of the CKiD population. 20 Importantly, almost one-half of patients in the CKiD cohort have a combination of traditional risk factors.…”

Section: Traditional Risk Factorsmentioning

confidence: 99%

Cardiovascular Disease in Children with Chronic Kidney Disease

Mitsnefes

2012

Journal of the American Society of Nephrology

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318

149

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More than a decade ago, cardiovascular disease (CVD) was recognized as a major cause of death in children with advanced CKD. This observation has sparked the publication of multiple studies assessing cardiovascular risk, mechanisms of disease, and early markers of CVD in this population. Similar to adults, children with CKD have an extremely high prevalence of traditional and uremia-related CVD risk factors. Early markers of cardiomyopathy, such as left ventricular hypertrophy and dysfunction, and early markers of atherosclerosis, such as increased carotid artery intima-media thickness, carotid arterial wall stiffness, and coronary artery calcification, are frequently present in these children, especially those on maintenance dialysis. As a population without preexisting symptomatic cardiac disease, children with CKD potentially receive significant benefit from aggressive attempts to prevent and treat CVD. Early CKD, before needing dialysis, is the optimal time to both identify modifiable risk factors and intervene in an effort to avert future CVD. Slowing the progression of CKD, avoiding long-term dialysis and, if possible, conducting preemptive transplantation may represent the best strategies to decrease the risk of premature cardiac disease and death in children with CKD.

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Section: Traditional Risk Factorsmentioning

confidence: 99%

Cardiovascular Disease in Children with Chronic Kidney Disease

Mitsnefes

2012

Journal of the American Society of Nephrology

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318

149

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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%

“…Fasting lipid levels were measured in a central laboratory (15). Dyslipidemia was defined by the presence of at least one of: hypertriglyceridemia (triglycerides Ͼ130 mg/dl), low HDL cholesterol (Ͻ40 mg/dl), elevated non-HDL cholesterol (Ͼ160 mg/dl), or use of lipid-lowering medication(s).…”

Section: Primary Outcomesmentioning

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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“…In this study, independent predictors for development of LVH include hypertension, female gender, and lower hemoglobin . Dyslipidemia is strongly associated with poor cardiovascular health, and dyslipidemia becomes more notable in those children with a comparatively lower GFR (<30 ml/min per 1.73 m2) and in the presence of nephroticrange proteinuria (Saland et al 2010). Even in moderate-stage CKD, anemia is a prevalent finding.…”

Section: Ckd and Sequelae Beyond The First Year Of Lifementioning

confidence: 99%

Chronic Kidney Disease: A Life Course Health Development Perspective

Brophy

Charlton

Carmody

et al. 2017

Handbook of Life Course Health Development

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Chronic kidney disease (CKD) reflects life events that range from maternal-fetal influences to geriatric exposures. The global direct and indirect costs of CKD are high and include maternal-neonatal hospitalization and treatment, acute kidney injury, dialysis and transplant, missed work, and medications, to name a few. The impact of poor diet, adverse childhood experiences, medication use, and failure to follow consistent public health standards are increasingly appreciated as key influences in the development of CKD. Socioeconomic factors can significantly influence the timing and phenotypic expression in people at risk for developing CKD, although more research is needed to understand these mechanisms. In general, biomedicine has been focused on treating well-established CKD morbidity. This strategy has been short sighted and costly. A more cost-effective approach would focus on early life interventions that hold the potential for mitigating CKD risk and its sequelae. This chapter applies the life course health development principles to review determinants and pathways for CKD evolution and identifies of the gaps in our knowledgebase. We also discuss several research strategies for evaluating the life course health development of CKD.

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Dyslipidemia in children with chronic kidney disease

Cited by 101 publications

References 53 publications

Cardiovascular Disease in Children with Chronic Kidney Disease

Cardiovascular Disease in Children with Chronic Kidney Disease

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

Chronic Kidney Disease: A Life Course Health Development Perspective

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