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Kidney Week

Abstract: SA-PO374

Lipid Levels in Pediatric Dialysis Patients with Glomerular and Non-Glomerular Disease

Session Information

  • Pediatric Nephrology - III
    November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Authors

  • Zitnik, Edward M., University of California Los Angeles, Los Angeles, California, United States
  • Laster, Marciana, University of California Los Angeles, Los Angeles, California, United States
Background

Children on dialysis have a 10-fold increase in cardiovascular disease (CVD) mortality when compared to the general population. The development of CVD in dialysis patients is in part attributed to progressive blood vessel calcification from CKD-MBD. Patients on dialysis are also more likely to have dyslipidemia, which further increases their risk of cardiovascular disease. While the prevalence of dyslipidemia in adult dialysis patients has been described, there is limited data on risk factors for pediatric dyslipidemia.

Methods

2,043 pediatric patients (≤21 years) receiving maintenance hemodialysis (HD) or peritoneal dialysis (PD) with at least one lipid panel measurement were obtained from USRDS between 2001 and 2016. Disease etiology was classified as glomerular (n=1,029), non-glomerular (n= 701) and unknown (n= 313) and comparisons were made across etiologies. Linear regression models determined the relationship between disease etiology and log-transformed LDL, HDL, triglyceride (TG) and total cholesterol (TC) levels drawn within 12 months of USRDS entry.

Results

The median(IQR) age of the cohort was 13 (17, 19.4). The majority of the cohort received HD as a primary modality and there were no differences between ESKD etiologies. Adjusting for age, gender, race/ethnicity, modality, time with ESKD and using non-glomerular etiology as the reference, glomerular disease [%(95% CI)] was associated with 21%(14.8, 26.6) higher LDL, 19%(14.7, 23.8) higher TC, and 22.3% (15.5, 29.5) higher TG (p<0.0001 for all). There was no significant difference in HDL.

Conclusion

Pediatric dialysis patients with ESKD from glomerular causes have higher levels of Total Cholesterol, LDL, and Triglycerides compared to children with ESKD from non-glomerular causes. The long-term impact of this unfavorable lipid profile requires further investigation.