Vascular function in children after renal transplantation

Lilien, Marc R.; Stroes, Erik S.G.; Roodt, Jos Op ‘t; Jongh, Saskia de; Schröder, Cornelis H.; Koomans, Hein A.

doi:10.1053/ajkd.2003.50131

Cited by 36 publications

(32 citation statements)

References 32 publications

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“…In a comparative study of patients who had received kidney transplantation and healthy controls, all children and adolescents aged 9 to 19 years, Lilien et al found endothelium-dependent vascular dilatation levels of 15.6±6.8% (mean±1 SD) for the controls, 22 which is similar to the result of the present study, although the age group did include children.…”

Section: Variablessupporting

confidence: 89%

“…However, all of these had patient samples that differed from ours, in particular in terms of age groups. 6,[18][19][20][21][22][23][24][25][26][27][28] While the studies found in the literature employed similar methodology for endothelial function assessment, the employed patient samples which, in addition to including individuals from wider age ranges than the age range of the adolescents in our study, also differ by not having exclusion criteria that could demonstrate that the patient sample was free from metabolic or functional bias.…”

Section: Discussionmentioning

confidence: 99%

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Função endotelial de adolescentes normotensos sem fatores de risco para hipertensão arterial

Andrade¹,

Carvalhaes²,

Taddei³

et al. 2005

J. Pediatr. (Rio J.)

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Objective: To define standards for normal endothelial function in adolescents by high-resolution ultrasound measurement of endothelium-dependent vascular dilatation.Methods: This was a cross-sectional, descriptive, observational study and part of the thematic project Clinical Study of Growth, Behavior, Arterial Hypertension, Obesity and Oral Health (ECCCHOS) that was developed by the Discipline of Nutrition at the Universidade Federal de São Paulo. Thirty-one adolescents, eight male and 23 female, with no risk factors for systemic arterial hypertension were selected from 1,420 high-school students. The students were daytime pupils at a school in the southeastern district of the city of São Paulo, the capital of São Paulo state, located in the Southeast region of Brazil. All results are presented in the form of means with standard deviations and percentiles.Results: For male students, endothelium-dependant dilation 90 seconds after the cuff was released was 20.9±6,7% [mean ±1 standard deviation] with a 10th percentile of 12.5 and for females these figures were 18.8±12.9% with a 10th percentile of 6.6%. Values for the whole group of subjects were 19.3±11.7% and 6.7%, respectively.Conclusion: Endothelium-dependant vascular dilation of 6.7%, after 90 seconds, which corresponds to the 10th percentile, can be considered the lower limit of normality for this age group. Knowledge of this limit is important for the diagnosis of endothelium dysfunction that appears before cardiovascular disease.J Pediatr (Rio J). 2005;81(5):395-9: Adolescents, endothelium, and ultrasound.

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Section: Variablessupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Função endotelial de adolescentes normotensos sem fatores de risco para hipertensão arterial

Andrade¹,

Carvalhaes²,

Taddei³

et al. 2005

J. Pediatr. (Rio J.)

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“…Endothelial dysfunction is characterized by an imbalance between nitric oxide (NO) bioavailability and oxidative stress [43]. Overall, 77% of patients showed endothelial dysfunction, which is well in line with previous studies in children and adult KTx patients [8][9][10][11]. Several in vitro studies suggest that mTOR inhibitors may impair endothelial cell function by inhibition of endothelial NO synthase (eNOS) activity [44][45][46].…”

Section: Discussionsupporting

confidence: 72%

Impaired Microcirculation in Children After Kidney Transplantation: Everolimus Versus Mycophenolate Based Immunosuppression Regimen

Ruben

Kreuzer

Büscher

et al. 2018

Kidney Blood Press Res

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Background/Aims: Whether the immunosuppressive regimen is associated with micro- and macro-vascular status in pediatric kidney transplant recipients (KTx) is unknown. Methods: We performed a cross-sectional, case-control study in 44 pediatric KTx patients on either everolimus (EVR) plus calcineurin inhibitor or standard treatment, i.e. mycophenolate mofetil plus calcineurin inhibitor. Measurement of carotid intima-media thickness (cIMT) via ultrasound, central pulse wave velocity (PWV) by a cuff-based oscillometric technique, and skin microvascular blood flow during local heating via laser-Doppler-fluximetry (LDF) served as marker of subclinical vascular disease. Serum concentrations of angiopoietin-1 and -2, fibroblast-growth factor 23 (FGF23) and soluble klotho were measured. Results: EVR-treated patients exhibited a similar degree of hypertension, increased cIMT, elevated pro-inflammatory angiopoietin-2, and diminished endothelial survival factor angiopoietin-1 compared to healthy children but presented with a twofold more reduced skin micro-vascular function compared to standard treatment (each p< 0.001). By contrast, PWV and soluble klotho levels were normal in both groups. Conclusion: Endothelial dysfunction seems more frequent in KTx patients on EVR-based immunosuppressive regimen compared to standard immunosuppression.

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“…277 In fact, some investigators hypothesize that any condition that produces systemic inflammation, as manifested by elevated high-sensitivity C-reactive protein, may produce endothelial dysfunction. 270 Another disorder that appears to promote vascular dysfunction in children is chronic renal failure, both before 278 and after 279 renal transplantation. Importantly, changes in FMD in chronic kidney disease could not be explained by classic cardiovascular risk factors such as hyperlipidemia.…”

Section: Data In Children and Adolescentsmentioning

confidence: 99%

Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents

Urbina

Williams²,

Alpert³

et al. 2009

Hypertension

554

274

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Abstract-Deterioration in endothelial function and arterial stiffness are early events in the development of cardiovascular diseases. In adults, noninvasive measures of atherosclerosis have become established as valid and reliable tools for refining cardiovascular risk to target individuals who need early intervention. With limited pediatric data, the use of these techniques in children and adolescents largely has been reserved for research purposes. Therefore, this scientific statement was written to (1) review the current literature on the noninvasive assessment of atherosclerosis in children and adolescents, (2) make recommendations for the standardization of these tools for research, and (3) stimulate further research with a goal of developing valid and reliable techniques with normative data for noninvasive clinical evaluation of atherosclerosis in pediatric patients. Precise and reliable noninvasive tests for atherosclerosis in youth will improve our ability to estimate future risk for heart attack and stroke. Currently, large longitudinal studies of cardiovascular risk factors in youth, such as the Bogalusa and Muscatine studies, lack sufficient adult subjects experiencing hard outcomes, such as heart attack and stroke, to produce meaningful risk scores like those developed from Framingham data.

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Vascular function in children after renal transplantation

Cited by 36 publications

References 32 publications

Função endotelial de adolescentes normotensos sem fatores de risco para hipertensão arterial

Função endotelial de adolescentes normotensos sem fatores de risco para hipertensão arterial

Impaired Microcirculation in Children After Kidney Transplantation: Everolimus Versus Mycophenolate Based Immunosuppression Regimen

Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents

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