RT Journal Article
SR Electronic
T1 Carotid Intima-Media Thickness in Children with CKD: Results from the CKiD Study
JF Clinical Journal of the American Society of Nephrology
JO CLIN J AM SOC NEPHROL
FD American Society of Nephrology
SP 1930
OP 1937
DO 10.2215/CJN.03130312
VO 7
IS 12
A1 Brady, Tammy M.
A1 Schneider, Michael F.
A1 Flynn, Joseph T.
A1 Cox, Christopher
A1 Samuels, Joshua
A1 Saland, Jeffrey
A1 White, Colin T.
A1 Furth, Susan
A1 Warady, Bradley A.
A1 Mitsnefes, Mark
YR 2012
UL http://cjasn.asnjournals.org/content/7/12/1930.abstract
AB Background and objectives In adults, increased carotid intima-media thickness (cIMT) as assessed by ultrasonography is a valid predictor of cardiovascular events. Children with CKD are known to be at increased cardiovascular risk. This study sought to identify cardiovascular risk factors associated with increased cIMT in children with CKD.Design, setting, participants, & measurements This was a cross-sectional analysis of cIMT obtained after 12 months of follow-up of 101 children aged 2–18 years with mild to moderate CKD (median GFR 42.9 ml/min per 1.73 m2) in the Chronic Kidney Disease in Children cohort study enrolled between April 2005 and September 2009 and 97 healthy pediatric controls between January 2003 and December 2008. An average of six standardized B-mode ultrasound measurements constituted the overall cIMT measurement.Results The median cIMT was 0.43 mm (interquartile range, 0.38–0.48) compared with 0.41 mm in healthy controls (P=0.03 for difference). After multivariable adjustment, the median cIMT was 0.02 mm (95% confidence interval [CI], 0.01–0.05) larger than that of the healthy controls. In a multivariable linear regression analysis, dyslipidemia and hypertension were associated with 0.05 mm (95% CI, 0.01–0.08) and 0.04 mm (95% CI, 0.003–0.08) greater mean cIMT, respectively. Body mass index, CKD etiology, GFR, birth weight, pubertal status, calcium, phosphorus, sex, and race were not associated with cIMT.Conclusions cIMT is significantly elevated among children with CKD, as is the prevalence of other cardiovascular risk factors. Of these risk factors, hypertension and dyslipidemia are significantly associated with increased cIMT.