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Abstract: TH-PO594

CKD Stage/Duration and Cardiovascular (CV) Risk Factors in Children With Proteinuric Glomerulopathies (GD)

Session Information

Category: Hypertension and CVD

  • 1501 Hypertension and CVD: Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Sethna, Christine B., Cohen Children's Medical Center, Queens, New York, United States
  • Meyers, Kevin E.C., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Srivastava, Tarak, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States
  • Massengill, Susan F., Levine Children's Hospital, Charlotte, North Carolina, United States
  • Weaver, Donald J., Levine Children's Hospital, Charlotte, North Carolina, United States
  • Gibson, Keisha L., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
  • Tuttle, Katherine R., Providence St Joseph Health, Renton, Washington, United States
  • Dell, Katherine MacRae, Case Western Reserve University, Cleveland, Ohio, United States
  • Gipson, Debbie, University of Michigan, Ann Arbor, Michigan, United States
  • Tran, Cheryl L., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Trachtman, Howard, University of Michigan, Ann Arbor, Michigan, United States
  • Mitchell, Elizabeth C., Cohen Children's Medical Center, Queens, New York, United States
Background

Children with GD are at increased risk for CV disease, however the impact of CKD stage and disease duration has not been well studied.

Methods

Ambulatory blood pressure monitoring (N=90), echocardiography (N=119), pulse wave velocity (PWV) (N=44) and lipids (N=96) were performed in a cross-sectional study of children <21 yr with GD from 10 sites within Nephrotic Syndrome Study Network (NEPTUNE) and Cure Glomerulonephropathy Network (CureGN). Data were also obtained from children with GD in the Chronic Kidney Disease in Children (CKiD) study. Blood pressures (BP) were indexed to the 95%ile. Left ventricular hypertrophy (LVH) was defined as >95%ile and >51 g/m2.7. The bedside Schwartz formula was used to estimate glomerular filtration rate (eGFR) and stage CKD. Disease duration was categorized as 0-<2, 2-<5, 5-<10 and >10 yrs. Analysis included Kruskal Wallis and chi-square tests.

Results

Of 144 children (age 14 [10.7-17] yr, 59% M), hypertension (HTN), isolated nocturnal HTN, LVH 95%ile and LVH>51were present in 38.9%, 20.9%, 28.6% and 10.1%, respectively. There was a higher proportion of HTN and LVH with higher CKD stages. Office BP, BP loads and triglycerides were also greater in higher CKD stages (Table). PWV was higher in those with disease duration 2-<5 years compared to other durations (6.15 vs. 4.5-5.26 m/s, p=0.03). No other measures were significantly different by disease duration.

Conclusion

CV risk factors are more prevalent in advanced CKD stages despite similar disease duration in children with GD. Longitudinal studies are needed to examine the effect of CKD stage/duration on CV risk factors in this high risk group.

Funding

  • Private Foundation Support