title: Echo-Doppler assessment of the biophysical properties of the aorta in children with chronic kidney disease.
abstract: Chronic kidney disease (CKD) is known to cause increased arterial stiffness, which is an important independent risk factor for adverse cardiovascular events. The purpose of this study was to assess the vascular properties of the aorta (AO) in a group of children with CKD using a noninvasive echocardiography (echo)-Doppler method. We studied 24 children with stages 2 through 5 CKD and 48 age-matched controls. Detailed echocardiographic assessment and echo-Doppler pulse wave velocity (PWV) was performed. Indices of arterial stiffness, including characteristic (Zc) and input (Zi) impedances, elastic pressure-strain modulus (Ep), and arterial wall stiffness index, were calculated. CKD patients underwent full nephrology assessment, and an iohexol glomerular filtration rate was performed, which allowed for accurate assignment of the CKD stage. CKD patients had greater median systolic blood pressure (114 vs. 110 mmHg; p < 0.04) and pulse pressure (51 vs. 40 mmHg; p < 0.001) compared with controls. PWV was similar between groups (358 vs. 344 cm s(-1); p = 0.759), whereas Zi (182 vs. 131 dyne s cm(-5); p < 0.001), Zc (146 vs. 138 dyne s cm(-5); p = 0.05), and Ep (280 vs. 230 mmHg; p < 0.02) were significantly greater in CKD than in controls. Although load-dependent measures of arterial stiffness were greater in non-dialysis dependent CKD patients, PWV was not increased compared with controls. This suggests that the increased arterial stiffness may not be permanent in these pediatric patients with kidney disease.
authors: Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital, The University of British Columbia, Vancouver, BC, Canada.
authors: Mohammed
authors: M
authors: Alghamdi
authors: Astrid M
authors: AM
authors: De Souza
authors: Colin T
authors: CT
authors: White
authors: M Terri
authors: MT
authors: Potts
authors: Bradley A
authors: BA
authors: Warady
authors: Susan L
authors: SL
authors: Furth
authors: Thomas R
authors: TR
authors: Kimball
authors: James E
authors: JE
authors: Potts
authors: George G S
authors: GG
authors: Sandor
mesh_terms: D000293:Adolescent; D001011:Aorta / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology*; D012307:Risk Factors; D059289:Vascular Stiffness
references: Am J Kidney Dis. 2005 Aug;46(2):320-7
references: 16112052
references: Am J Kidney Dis. 2005 Mar;45(3):494-501
references: 15754271
references: Kidney Int. 2006 Jun;69(11):2070-7
references: 16612328
references: J Am Soc Nephrol. 2005 Sep;16(9):2796-803
references: 16049067
references: Circulation. 2006 Feb 7;113(5):657-63
references: 16461838
references: J Clin Hypertens (Greenwich). 2006 Jun;8(6):398-403
references: 16760677
references: Circulation. 1991 Jun;83(6):1849-65
references: 1828192
references: Arterioscler Thromb Vasc Biol. 2003 Apr 1;23(4):554-66
references: 12615661
references: Clin Nephrol. 2007 Sep;68(3):133-43
references: 17915615
references: Artery Res. 2010 Mar 1;4(1):27-31
references: 20396400
references: Curr Opin Pediatr. 2007 Oct;19(5):538-45
references: 17885471
references: J Am Soc Echocardiogr. 2006 Dec;19(12):1413-30
references: 17138024
references: J Hypertens. 2008 Jul;26(7):1305-6
references: 18551002
references: Pediatrics. 2008 Jul;122(1):198-208
references: 18596007
references: Pediatr Nephrol. 2008 Dec;23(12):2241-5
references: 18584211
references: Pediatrics. 1998 Jan;101(1 Pt 1):141-7
references: 11345978
references: J Pediatr. 2010 Mar;156(3):388-92
references: 19939406
references: Cardiovasc Ther. 2008 Fall;26(3):214-23
references: 18786091
references: J Am Soc Echocardiogr. 2010 Jul;23(7):735-40
references: 20605403
references: J Am Coll Cardiol. 2009 Aug 4;54(6):505-12
references: 19643310
references: Pediatr Nephrol. 1993 Dec;7(6):749-57
references: 8130098
references: Am J Kidney Dis. 2005 Jun;45(6):965-77
references: 15957125
references: Heart. 2006 Feb;92(2):228-32
references: 15814594
references: Pediatr Pathol Mol Med. 2002 Mar-Apr;21(2):213-37
references: 11942537
references: J Am Coll Cardiol. 2010 Mar 30;55(13):1318-27
references: 20338492
references: Curr Opin Pediatr. 2002 Apr;14(2):197-204
references: 11981290
references: Nephrology (Carlton). 2007 Oct;12(5):500-9
references: 17803475
references: Echocardiography. 2011 Jan;28(1):29-37
references: 21198821
references: Nat Rev Nephrol. 2009 Apr;5(4):229-35
references: 19322188
references: Am J Cardiol. 2005 Nov 1;96(9):1317-21
references: 16253606
references: J Am Soc Echocardiogr. 2003 Jul;16(7):745-50
references: 12835661
references: Hypertension. 2004 Feb;43(2):163-8
references: 14732732
references: Nephrol Dial Transplant. 2006 Mar;21(3):729-35
references: 16221688
references: Clin Exp Hypertens. 2004 Oct-Nov;26(7-8):689-99
references: 15702623
references: Curr Opin Nephrol Hypertens. 2008 Nov;17(6):635-41
references: 19031658
references: J Am Soc Nephrol. 2009 Mar;20(3):629-37
references: 19158356
references: Circulation. 2006 Feb 7;113(5):664-70
references: 16461839
references: Semin Dial. 2003 Mar-Apr;16(2):101-5
references: 12641872
references: Eur Heart J. 2006 Nov;27(21):2588-605
references: 17000623
references: Clin Exp Pharmacol Physiol. 2007 Jul;34(7):647-51
references: 17581224
references: Pediatr Res. 2008 Jan;63(1):95-8
references: 18043514
references: J Nephrol. 2007 Nov-Dec;20 Suppl 12:S45-50
references: 18050143