title: Evaluation of arterial structure and function in pediatric patients with end-stage renal disease on dialysis and after renal transplantation.
abstract: CVD is a major cause of morbidity and mortality in pediatric patients with CKD. It is unclear whether vascular abnormalities in these patients are reversible, and if transplantation portends salutary effects on arterial function. We compared FMD, PWV, AI75, and CIMT in 15 dialysis (D), 14 transplant patients (T), and 15 controls (C), and their associations with cardiovascular risk factors. There was stepwise lower FMD (p < 0.001), higher AI75 (p < 0.001), higher PWV (p = 0.01), and higher CIMT SDS for age (p = 0.03) and height (p = 0.006) in the D group than T and C groups. FMD, PWV, and CIMT were unrelated to dialysis duration or time from transplantation. On multivariate analysis, group status was independently associated with FMD (β = 3.15, p = 0.002), AI75 (β = -5.95, p = 0.01), PWV (β = -0.57, p = 0.07) and CIMT (β = -0.02, p = 0.04) and CIMT SDS for height (β = -0.541, p = 0.009). FMD is lower and AI75, PWV and CIMT are higher in pediatric patients maintained on D than T/C. T patients have similar AI75, PWV and CIMT to C although FMD remains reduced. These findings suggest that transplantation stabilizes or improves CKD associated arteriopathy.
authors.affiliation: Department of Pediatrics, Division of Pediatric Nephrology, State University of New York Downstate Medical Center, Brooklyn, NY, USA.
authors.forename: Hanan
authors.initials: H
authors.lastname: Tawadrous
authors.forename: Haroon
authors.initials: H
authors.lastname: Kamran
authors.forename: Louis
authors.initials: L
authors.lastname: Salciccioli
authors.forename: Morris J
authors.initials: MJ
authors.lastname: Schoeneman
authors.forename: Jason
authors.initials: J
authors.lastname: Lazar
mesh_terms: D000293:Adolescent; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D059168:Carotid Intima-Media Thickness; D002648:Child; D003430:Cross-Sectional Studies; D003935:Diagnostic Techniques, Cardiovascular; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000473:pathology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D016030:Kidney Transplantation; D008297:Male; D015999:Multivariate Analysis; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D006435:Renal Dialysis; D016896:Treatment Outcome; D059289:Vascular Stiffness; D014664:Vasodilation