title: Intima media thickness in children undergoing dialysis.
abstract: BACKGROUND
  Uremic vasculopathy, including vascular calcification, increases the risk for cardiovascular disease and mortality in chronic kidney disease (CKD) patients. We have investigated the prevalence and factors associated with vasculopathy in children undergoing peritoneal dialysis (PD) or hemodialysis (HD) in a single center.
  
  
  METHODS
  Common carotid intima media thickness (cIMT) and its relation with demographics, biochemical parameters and medication was analyzed in 60 patients (mean age 12.9 ± 3.4 years; 27 girls) treated with PD (n = 31) or HD (n = 29) for 34 ± 34 months. Patients were divided into two groups: normal cIMT and increased cIMT.
  
  
  RESULTS
  Mean levels of calcium, phosphate and calcium/phosphate product were in the normal range, the but parathyroid hormone level, 729 ± 670 pg/mL, was higher than the National Kidney Foundation Kidney Disease Outcome Quality Iniative (K/DOQI) recommendations. Twenty-nine patients had increased cIMT, which was associated with time on dialysis of >2 years, hypercalcemia, higher daily dose of calcitriol and HD (vs. PD). In the multivariate analysis, accounting for time on dialysis, HD persisted as a risk for increased cIMT.
  
  
  CONCLUSIONS
  The prevalence of increased cIMT in children on dialysis is similar to that reported in adults with CKD and increased with time on dialysis. HD was associated with increased cIMT, independently of time on dialysis; however, the results should be interpreted with caution due to the possible impact of confounding factors. These results underline the need to monitor and, if possible, prevent and treat increased cIMT in children on dialysis.
authors.affiliation: Departamento de Nefrologia, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico.
authors.forename: Luis Antonio
authors.initials: LA
authors.lastname: Chavarria
authors.forename: Alejandra
authors.initials: A
authors.lastname: Aguilar-Kitsu
authors.forename: Patricia
authors.initials: P
authors.lastname: Rosas
authors.forename: Arturo
authors.initials: A
authors.lastname: Fajardo
authors.forename: Leticia
authors.initials: L
authors.lastname: Mendoza-Guevara
authors.forename: Lorena
authors.initials: L
authors.lastname: Sanchez
authors.forename: Claudia
authors.initials: C
authors.lastname: Zepeda
authors.forename: Pilar
authors.initials: P
authors.lastname: Ibarra
authors.forename: Alejandro
authors.initials: A
authors.lastname: Luna
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindholm
authors.forename: Elvia
authors.initials: E
authors.lastname: García-López
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D059168:Carotid Intima-Media Thickness; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D010530:Peritoneal Dialysis / Q000009:adverse effects*; D015995:Prevalence; D006435:Renal Dialysis / Q000009:adverse effects*