Early Effects of Renal Replacement Therapy on Cardiovascular Comorbidity in Children With End-Stage Kidney Disease

Schmidt, Bernhard M.W.; Sugianto, Rizky Indrameikha; Thurn, Daniela; Ažukaitis, Karolis; Bayazıt, Aysun Karabay; Canpolat, Nur; Eroğlu, Ayşe Güler; Çalışkan, Salim; Doyon, Anke; Düzova, Ali; Karagöz, Tevfik; Anarat, Ali; Devecí, Murat; Mır, Sevgı; Ranchin, Bruno; Shroff, Rukshana; Baskın, Esra; Litwin, Mieczysław; Özçakar, Z. Bı̇rsı̇n; Söylemezoğlu, Oğuz; Dušek, Jiří; Kemper, Markus J.; Matteucci, Maria Chiara; Habbig, Sandra; Laube, Guido F.; Wühl, Elke; Querfeld, Uwe; Sander, Anja; Schaefer, Franz; Melk, Anette

doi:10.1097/tp.0000000000001948

Cited by 34 publications

(30 citation statements)

References 48 publications

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“…Our data also highlights the clinical importance of an even faster access for girls to transplantation, especially in light of studies showing a slower access to pre-emptive transplantation 6,22 . A longer time on dialysis was associated with increased PWV, which is in line with our previous finding showing the advantage of preemptive transplantation compared to dialysis 18 . The observed association between higher BP and higher PWV in both sexes is in accordance with previous findings in the general pediatric population 60,61 , in various patient groups 15,17,62 and after kidney transplantation 18,63 .…”

Section: J O U R N a L P R E -P R O O Fsupporting

confidence: 91%

“…PWV increased further after transplantation. In previous studies PWV tended to stabilize or slightly decrease during the first year after kidney transplantation 18,[56][57][58] , but longer observation in adults revealed an increase of PWV 59 . The increase of PWV post-transplantation with time likely reflects an ongoing damage even after transplantation in addition to the "pre-existing" burden from the time pre-KRT.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 69%

“…Higher PWV was demonstrated in children with CKD even after transplantation compared to their healthy peers [15][16][17][18] .…”

Section: Introductionmentioning

confidence: 99%

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Findings from 4C-T Study demonstrate an increased cardiovascular burden in girls with end stage kidney disease and kidney transplantation

Sugianto

Memaran

Schmidt

et al. 2022

Kidney International

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Section: J O U R N a L P R E -P R O O Fsupporting

confidence: 91%

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 69%

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Findings from 4C-T Study demonstrate an increased cardiovascular burden in girls with end stage kidney disease and kidney transplantation

Sugianto

Memaran

Schmidt

et al. 2022

Kidney International

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“…We demonstrated an association between LVMI and nocturnal systolic and diastolic BP. In a study of the prognostic effect of nocturnal hypertension, nocturnal systolic BP elevation and reverse nocturnal dipping independently predicted CV events in adults 15,40,41 . As LVH is an early marker of CVD in children, our high rates of LVH may therefore be explained by the prevalence of isolated nocturnal HTN.…”

Section: Discussionmentioning

confidence: 93%

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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“…Our data suggest that the superior growth outcome in children undergoing pre-emptive or living donor KT reported from some but not all uncontrolled studies is probably not related to the procedure per se but rather due to associated factors like better graft function, lower steroid exposure, and/or better-preserved growth at the time of KT in these patients [ 5 , 6 , 9 , 15 ]. Nevertheless, (pre-emptive) living donor KT remains the treatment of choice in children with CKD 5 due to its superior outcome with respect to neurocognitive development, quality of life, and cardiovascular health [ 38 – 40 ].…”

Section: Discussionmentioning

confidence: 99%

Determinants of growth after kidney transplantation in prepubertal children

et al. 2021

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Background Short stature is a frequent complication after pediatric kidney transplantation (KT). Whether the type of transplantation and prior treatment with recombinant human growth hormone (GH) affects post-transplant growth, is unclear. Methods Body height, leg length, sitting height, and sitting height index (as a measure of body proportions) were prospectively investigated in 148 prepubertal patients enrolled in the CKD Growth and Development study with a median follow-up of 5.0 years. We used linear mixed-effects models to identify predictors for body dimensions. Results Pre-transplant Z scores for height (− 2.18), sitting height (− 1.37), and leg length (− 2.30) were reduced, and sitting height index (1.59) was increased compared to healthy children, indicating disproportionate short stature. Catch-up growth in children aged less than 4 years was mainly due to stimulated trunk length, and in older children to improved leg length, resulting in normalization of body height and proportions before puberty in the majority of patients. Use of GH in the pre-transplant period, congenital CKD, birth parameters, parental height, time after KT, steroid exposure, and transplant function were significantly associated with growth outcome. Although, unadjusted growth data suggested superior post-transplant growth after (pre-emptive) living donor KT, this was no longer true after adjusting for the abovementioned confounders. Conclusions Catch-up growth after KT is mainly due to stimulated trunk growth in young children (< 4 years) and improved leg growth in older children. Beside transplant function, steroid exposure and use of GH in the pre-transplant period are the main potentially modifiable factors associated with better growth outcome.

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Early Effects of Renal Replacement Therapy on Cardiovascular Comorbidity in Children With End-Stage Kidney Disease

Cited by 34 publications

References 48 publications

Findings from 4C-T Study demonstrate an increased cardiovascular burden in girls with end stage kidney disease and kidney transplantation

Findings from 4C-T Study demonstrate an increased cardiovascular burden in girls with end stage kidney disease and kidney transplantation

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

Determinants of growth after kidney transplantation in prepubertal children

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