title: Dyslipidaemia in children on renal replacement therapy.
abstract: BACKGROUND
  Information on lipid abnormalities in end-stage renal disease (ESRD) mainly originates from adult patients and small paediatric studies. We describe the prevalence of dyslipidaemia, and potential determinants associated with lipid measures in a large cohort of paediatric ESRD patients.
  
  
  METHODS
  In the ESPN/ERA-EDTA registry, lipid measurements were available for 976 patients aged 2-17 years from 19 different countries from the year 2000 onwards. Dyslipidaemia was defined as triglycerides >100 mg/dL (2-9 years) or >130 mg/dL (9-17 years), high-density lipoprotein (HDL) cholesterol <40 mg/dL or non-HDL cholesterol >145 mg/dL. Missing data were supplemented using multiple imputation.
  
  
  RESULTS
  The prevalence of dyslipidaemia was 85.1% in peritoneal dialysis (PD) patients, 76.1% in haemodialysis (HD) patients and 55.5% among renal allograft recipients. Both low and high body mass index (BMI) were associated with a less favourable lipid profile. Younger age was associated with a worse lipid profile among PD patients. HDL levels significantly improved after transplantation, whereas no significant improvements were found for triglyceride and non-HDL levels. In transplant recipients, use of cyclosporin was associated with significantly higher non-HDL and HDL levels than tacrolimus usage (P < 0.01). In transplant patients with eGFR < 29 mL/min/1.73 m(2), the mean triglyceride level was 137 mg/dL (99% confidence interval (CI): 119-159) compared with 102 mg/dL among those with eGFR > 90 mL/min/1.73 m(2) (P < 0.0001).
  
  
  CONCLUSIONS
  Dyslipidaemia is common among paediatric ESRD patients in Europe. Young age and PD treatment are associated with worse lipid profiles. Although lipid levels generally improve after transplantation, dyslipidaemia may persist due to decreased graft function, high BMI or to the use of certain immunosuppressants.
authors.affiliation: ESPN/ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: Bonthuis
authors.forename: Karlijn J
authors.initials: KJ
authors.lastname: van Stralen
authors.forename: Kitty J
authors.initials: KJ
authors.lastname: Jager
authors.forename: Sergey
authors.initials: S
authors.lastname: Baiko
authors.forename: Timo
authors.initials: T
authors.lastname: Jahnukainen
authors.forename: Guido F
authors.initials: GF
authors.lastname: Laube
authors.forename: Ludmila
authors.initials: L
authors.lastname: Podracka
authors.forename: Tomás
authors.initials: T
authors.lastname: Seeman
authors.forename: Kay
authors.initials: K
authors.lastname: Tyerman
authors.forename: Tim
authors.initials: T
authors.lastname: Ulinski
authors.forename: Jaap W
authors.initials: JW
authors.lastname: Groothoff
authors.forename: Franz
authors.initials: F
authors.lastname: Schaefer
authors.forename: Enrico
authors.initials: E
authors.lastname: Verrina
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D008076:Cholesterol, HDL / Q000097:blood; D050171:Dyslipidemias / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D010530:Peritoneal Dialysis; D015995:Prevalence; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides
keywords: children; dialysis; dyslipidaemia; renal replacement therapy; transplantation