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Abstract: SA-PO356

Increasing Cardiovascular Burden Among Young Adults with Pediatric CKD at Time of Transition to Adult Care

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

  • Mitsnefes, Mark, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  • Flynn, Joseph T., Seattle Children's Hospital, Seattle, Washington, United States
  • Patel, Ankur K., Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Furth, Susan L., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Warady, Bradley A., Children's Mercy Kansas City, Kansas City, Missouri, United States
  • Ng, Derek K., Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States

Group or Team Name

  • Chronic Kidney Disease in Children Study.
Background

Transition to adult care for young adults with pediatric chronic kidney disease (CKD) is critical phase of clinical care and may present challenges for cardiovascular disease (CVD) management. To investigate CVD burden among young adults, we assessed the prevalence of cardiovascular and metabolic comorbidities among participants > 18 years and compared to the same participants prior to age 18.

Methods

Using data from the Chronic Kidney Disease in Children (CKiD) study, we estimated prevalence of high blood pressure (elevated, Stage 1 or 2), obesity, and hyperglycemia before and after age 18 among those who reached young adulthood free of ESKD. Logistic models with generalized estimating equations for prevalence odds ratios (older vs. younger) for each comorbidity, adjusting for GFR, proteinuria and diagnosis.

Results

Among 313 participants who attained age 18 with an average GFR of 47 ml/min|1.73m2, the prevalence of high blood pressure (BP) was 38% among young adults (864 person-visits) with a median age was 19.8 [IQR: 18.8, 21.1], compared to 26% among the same participants prior to age 18 (1332 person-visits) at a median age 15.2 [12.8, 16.7] with an average GFR of 50. There were no significant differences in obesity (21% vs. 19%) or hyperglycemia (6% vs. 7%). Older age was associated with an unadjusted prevalence odds ratio for high BP of 1.70 (95%CI: 1.40 to 2.09), which remained significant in an adjusted model (OR: 1.63, 1.30 to 2.04).

Conclusion

Among young adults with pediatric CKD who had not reached ESKD, the prevalence of high BP was significantly higher compared to when they were younger. Adult nephrologists receiving patients with pediatric CKD should be vigilant for the potential worsening of BP control during the transition period.

Funding

  • NIDDK Support