title: Dyslipidemia in children with chronic kidney disease.
abstract: Dyslipidemia, a known risk factor for atherosclerosis, is frequent among both adults and children with chronic kidney disease. Here, we describe the prevalence and pattern of dyslipidemia from a cross-sectional analysis of 391 children aged 1-16 years, enrolled in the multicenter Chronic Kidney Disease in Children (CKiD) study, with a median glomerular filtration rate (GFR), measured by the plasma disappearance of iohexol, of 43 ml/min per 1.73 m2. Multivariate analysis was applied to adjust for age, gender, body mass index (BMI), GFR, and the urinary protein/creatinine ratio. Proteinuria was in the nephrotic range in 44 and the BMI exceeded the 95th percentile in 57 patients of this cohort. Baseline lipid analysis found a high prevalence of hypertriglyceridemia in 126, increased non-HDL-C in 62, and reduced HDL-C in 83. Overall, 177 children had dyslipidemia, of whom 79 had combined dyslipidemia. Lower GFR was associated with higher triglycerides, lower HDL-C, and higher non-HDL-C. Nephrotic-range proteinuria was significantly associated with dyslipidemia and combined dyslipidemia. Compared with children with a GFR>50, children with a GFR<30 had significantly increased odds ratios for any dyslipidemia or for combined dyslipidemia. Hence, among children with moderate chronic kidney disease, dyslipidemia is common and is associated with lower GFR, nephrotic proteinuria, and non-renal factors including age and obesity.
authors.affiliation: Department of Pediatrics, The Mount Sinai School of Medicine, New York, New York 10029, USA. Jeff.Saland@mssm.edu
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Saland
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Pierce
authors.forename: Mark M
authors.initials: MM
authors.lastname: Mitsnefes
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Flynn
authors.forename: Jens
authors.initials: J
authors.lastname: Goebel
authors.forename: Juan C
authors.initials: JC
authors.lastname: Kupferman
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Warady
authors.forename: Susan L
authors.initials: SL
authors.lastname: Furth
mesh_terms: D000293:Adolescent; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D002908:Chronic Disease; D003287:Contrast Media; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D015228:Hypertriglyceridemia / Q000453:epidemiology; D007223:Infant; D007472:Iohexol; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000453:epidemiology* / Q000503:physiopathology; D016014:Linear Models; D008297:Male; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D011507:Proteinuria / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D008076:Cholesterol, HDL; D003287:Contrast Media; D014280:Triglycerides; D007472:Iohexol; D002784:Cholesterol