title: Determinants of the intima-media thickness in children and adolescents with chronic kidney disease.
abstract: The aim of the study was to evaluate changes in the arterial wall in children with chronic kidney disease (CKD). We studied 60 patients: 32 with stages 2-4 CKD [chronic renal failure (CRF)], 28 with stage 5 CKD [end-stage renal disease (ESRD)], and 43 controls (C). The evaluated parameters included intima-media thickness (IMT) of the carotid arteries, bone mineral density (BMD), serum lipid levels, and parameters of the calcium-phosphorus metabolism. Patients were divided into two groups: group 1 with normal arteries, and group 2 with arterial changes. The highest serum fetuin A level was found in group 1 compared with groups 2 and C. A negative correlation between IMT and fetuin A level was found. In patients with ESRD, a positive correlation of IMT with phosphorus level and age and a negative correlation with cyclase-activating parathyroid hormone and cyclase inhibiting parathyroid hormone (CAP/CIP) ratio was observed. Multiple linear regression showed that lower fetuin-A and alkaline phosphatase (AP) levels and higher lumbar spine BMD independently predicted higher IMT. Arterial wall changes in children with CKD were related to lower fetuin A and AP level and higher BMD. Low CAP/CIP and high phosphorus level may also be significant factors for arterial changes in patients with ESRD.
authors.affiliation: Department of Pediatrics and Nephrology, Medical University of Warsaw, Marszałkowska 24, Warsaw, Poland. helenaziolk@op.pl
authors.forename: Helena
authors.initials: H
authors.lastname: Ziolkowska
authors.forename: Michal
authors.initials: M
authors.lastname: Brzewski
authors.forename: Maria
authors.initials: M
authors.lastname: Roszkowska-Blaim
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D001798:Blood Proteins / Q000378:metabolism; D015519:Bone Density; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000378:metabolism; D010758:Phosphorus / Q000378:metabolism; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D018608:Ultrasonography, Doppler; D060749:alpha-2-HS-Glycoprotein
chemical_list: C556354:AHSG protein, human; D001798:Blood Proteins; D060749:alpha-2-HS-Glycoprotein; D010758:Phosphorus; D000469:Alkaline Phosphatase