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Abstract: PO2260

Cardiovascular Outcomes in Pediatric CKD: A CKiD Study

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Raina, Rupesh, Cleveland Clinic, Akron, Ohio, United States
  • Chakraborty, Ronith, Cleveland Clinic, Akron, Ohio, United States
  • Singh, Siddhartha S., Cleveland Clinic, Akron, Ohio, United States
  • Cha, Stephen D., Akron Children's Hospital, Akron, Ohio, United States
Background

Cardiovascular Disease (CVD) poses high risk to Chronic Kidney Disease (CKD) pediatric patients with existing literature noting decreased mortality and other comorbidities. Here, we use the Chronic Kidney Disease in Children Cohort Study (CKiD), a prospective cohort study of pediatric renal cystic patients, to assess CVD parameters in this vulnerable population.

Methods

We performed control-matched analysis of CKiD patents with renal cystic disease (PKD, MCDK, BOR) compared to a group of aplastic/dysplastic/hypoplastic kidney patients or those with obstructive uropathy. Variables were normalized using the Kolmogorov-Smirnov test; categorical variables were summarized as percentages while continuous variables as medians and inter-quartile ranges. Univariate associations were tested using chi-square statistic or Fischer exact test for categorical variables and Mann-Whitney I test for continuous variables.

Results

41 patients in the renal cystic group were compared to 294 patients in the non-renal non-cystic group. Renal cystic patients demonstrated statistically significant increases in cystatin-C with no difference in iGFR or serum creatinine. Blood pressure was decreased [103 (97 - 112) vs. 107 (99 - 115) mm Hg; p=0.004] in the renal cystic group but cardiac parameters of ascending aortic stiffness [3.1 (2.11 - 5.21) vs. 2.53 (1.87 - 3.56); p=0.001] and incidence of left-ventricular hypertrophy (LVH) [12 (15.2%) vs. 44 (8.3%); p=0.049] was increased.

Conclusion

CVD mortality is the primary cause of death in patients with CKD, especially ADPKD. Previous literature conceptualized link between renal cystic disease and hypertension leading to poorer CVD outcomes however our analyses show this is an incomplete picture with almost 50% higher incidence of LVH but lower blood pressure in renal cystic group compared to other CKD pediatric patients. This suggests a need for further exploration of cardiac remodeling and structural changes to improve the understanding of CVD development in renal cystic pediatric patients.