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Öğe THE 4C-T STUDY - CARDIOVASCULAR COMORBIDITY IN CHILDREN WITH CKD AND RENAL TRANSPLANTATION(Wiley-Blackwell, 2013) Melk, A.; Kracht, D.; Doyon, A.; Zeller, R.; Litwin, M.; Duzowa, A.; Sozeri, B.; Bayasit, A.; Caliskan, S.; Querfeld, U.; Wuehl, E.; Schaefer, F.; Schmidt, B.Öğe CARDIOVASCULAR COMORBIDITY IN CHILDREN WITH CHRONIC KIDNEY DISEASE (CKD) AND TRANSPLANTATION - THE 4C-T STUDY(Oxford Univ Press, 2013) Melk, A.; Kracht, D.; Doyon, A.; Zeller, R.; Litwin, M.; Duzowa, A.; Soezen, B.; Bayzit, A.; Caliskan, S.; Querfeld, U.; Wuehl, E.; Schaefer, F.; Schmidt, B.Öğe Carotid intima media thickness in children with Chronic Kidney Disease (CKD): baseline results of the 4C study(Springer, 2011) Doyon, A.; Bayazit, A. K.; Canpolat, N.; Duzovav, A.; Kracht, D.; Litwin, M.; Sozeri, B.; Zeller, R.; Querfeld, U.; Schaefer, F.Öğe Effects of nutritional vitamin D supplementation on markers of bone and mineral metabolism in children with chronic kidney disease(Oxford Univ Press, 2018) Lerch, Christian; Shroff, Rukshana; Wan, Mandy; Rees, Lesley; Aitkenhead, Helen; Bulut, Ipek Kaplan; Thurn, Daniela; Bayazit, Aysun Karabay; Niemirska, Anna; Canpolat, Nur; Duzova, Ali; Azukaitis, Karolis; Yilmaz, Ebru; Yalcinkaya, Fatos; Harambat, Jerome; Kiyak, Aysel; Alpay, Harika; Habbig, Sandra; Zaloszyc, Ariane; Soylemezoglu, Oguz; Candan, Cengiz; Rosales, Alejandra; Melk, Anette; Querfeld, Uwe; Leifheit-Nestler, Maren; Sander, Anja; Schaefer, Franz; Haffner, Dieter; Cortina, G.; Arbeiter, K.; Dusek, J.; Harambat, J.; Ranchin, B.; Fischbach, M.; Zalosczyk, A.; Querfeld, U.; Habbig, S.; Galiano, M.; Buescher, R.; Gimpel, C.; Kemper, M.; Melk, A.; Thurn, D.; Schaefer, F.; Doyon, A.; Wuehl, E.; Pohl, M.; Wygoda, S.; Jeck, N.; Kranz, B.; Wigger, M.; Montini, G.; Lugani, F.; Testa, S.; Vidal, E.; Matteucci, C.; Picca, S.; Jankauskiene, A.; Azukaitis, K.; Zurowska, A.; Drodz, D.; Tkaczyk, M.; Urasinski, T.; Litwin, M.; Niemirska, A.; Szczepanska, M.; Texeira, A.; Peco-Antic, A.; Bucher, B.; Laube, G.; Anarat, A.; Bayazit, A. K.; Yalcinkaya, F.; Basin, E.; Cakar, N.; Soylemezoglu, O.; Duzova, A.; Bilginer, Y.; Erdogan, H.; Donmez, O.; Balat, A.; Kiyak, A.; Caliskan, S.; Canpolat, N.; Candan, C.; Civilibal, M.; Emre, S.; Alpay, H.; Ozcelik, G.; Mir, S.; Sozeri, B.; Yavascan, O.; Tabel, Y.; Ertan, P.; Yilmaz, E.; Shroff, R.; Prytula, A.; Bachetta, J.; Haffner, D.; Klaus, G.; Gessner, M.; Schmitt, C. P.; Stabouli, S.; Reusz, G.; Verrina, E.; Groothoff, J.; Tondel, C.; Gamero, M. A.; Petrosyan, E.; Bakkaloglu, S. A.; Dursun, I.; Shroff, R.Background. We investigated the effects of nutritional vitamin D supplementation on markers of bone and mineral metabolism, i.e. serum levels of fibroblast growth factor 23 (FGF23), Klotho, bone alkaline phosphatase (BAP) and sclerostin, in two cohorts with chronic kidney disease (CKD). Methods. In all, 80 vitamin D-deficient children were selected: 40 with mild to moderate CKD from the ERGO study, a randomized trial of ergocalciferol supplementation [ estimated glomerular filtration rate (eGFR) 55 mL/min/1.73 m(2)], and 40 with advanced CKD from the observational Cardiovascular Comorbidity in Children with Chronic Kidney Disease (4C) study (eGFR 24 mL/min/1.73 m2). In each study, vitamin D supplementation was started in 20 children and 20 matched children not receiving vitamin D served as controls. Measures were taken at baseline and after a median period of 8 months. Age- and gender-related standard deviation scores (SDSs) were calculated. Results. Before vitamin D supplementation, children in the ERGO study had normal FGF23 (median 0.31 SDS) and BAP (-0.10 SDS) but decreased Klotho and sclerostin (-0.77 and -1.04 SDS, respectively), whereas 4C patients had increased FGF23 (3.87 SDS), BAP (0.78 SDS) and sclerostin (0.76 SDS) but normal Klotho (-0.27 SDS) levels. Vitamin D supplementation further increased FGF23 in 4C but not in ERGO patients. Serum Klotho and sclerostin normalized with vitamin D supplementation in ERGO but remained unchanged in 4C patients. BAP levels were unchanged in all patients. In the total cohort, significant effects of vitamin D supplementation were noted for Klotho at eGFR 40-70 mL/min/1.73 m(2). Conclusions. Vitamin D supplementation normalized Klotho and sclerostin in children with mild to moderate CKD but further increased FGF23 in advanced CKD.Öğe Longitudinal Follow-Up of Cardiovascular Comorbidity in Pediatric Renal Transplant Recipients - Results From the 4C-T Study(Wiley-Blackwell, 2014) Melk, A.; Kracht, D.; Duzowa, A.; Soezeri, B.; Bayazit, A.; Caliskan, S.; Querfeld, U.; Doyon, A.; Schaefer, F.; Wuehl, E.; Schmidt, B.Öğe Longitudinal Follow-Up of Cardiovascular Comorbidity in Pediatric Renal Transplant Recipients - Results From the 4C-T Study.(Lippincott Williams & Wilkins, 2014) Melk, A.; Kracht, D.; Duzowa, A.; Soezeri, B.; Bayazit, A.; Caliskan, S.; Querfeld, U.; Doyon, A.; Schaefer, F.; Wuehl, E.; Schmidt, B.Öğe Stricter Blood Pressure Control Is Associated With Lower Left Ventricular Mass in Children After Kidney Transplantation: A Longitudinal Analysis of the 4C-T Study(Lippincott Williams and Wilkins, 2023) Sugianto, R.I.; Grabitz, C.; Bayazıt, A.; Duzova, A.; Thurn-Valsassina, D.; Memaran, N.; Doyon, A.BACKGROUND: We assessed the effect of blood pressure (BP) control on left ventricular mass index (LVMI) and left ventricular hypertrophy (LVH). METHODS: Ninety-six patients (64 males) ?9 months post-kidney transplantation from the 4C-T (Cardiovascular Comorbidity in Children with Chronic Kidney Disease and Transplantation) study were analyzed longitudinally (mean follow-up, 2.6±1.3 years). Cumulative systolic blood pressure (SBP)/diastolic BP exposure was calculated as a time-averaged area under the curve and categorized: ?50th, 50th to ?75th, 75th to ?90th, and >90th percentile (pct). We performed adjusted linear and logistic mixed models for LVMI and LVH, respectively. RESULTS: At baseline, LVMI was 49.7±12.7g/m2.16 with 64% (n=61) kidney transplantation recipients displaying LVH. Compared with patients with cumulative SBP exposure >90th pct, patients with cumulative SBP of 50th to ?75th showed a significant LVMI reduction of -5.24g/m2.16 (P=0.007). A similar tendency was seen for cumulative SBP?50th (?=-3.70 g/m2.16; P=0.067), but patients with cumulative SBP of 75th to ?90th pct showed no reduction. A post hoc analysis in patients with cumulative SBP?75th revealed that median SBP exposure was at 57.5th pct. For cumulative diastolic BP, a significant LVMI reduction was seen in all 3 categories ?90th pct compared with patients >90th pct. Patients with cumulative SBP of ?50th or 50th to ?75th pct showed 79% or 83% lower odds of developing LVH, respectively. Patients with cumulative diastolic BP ?50th showed a tendency of 82% lower odds for LVH (95% CI, 0.03-1.07). CONCLUSIONS: Stricter BP control led to regression of LVMI and LVH. Our data suggest a BP target below the 60th pct, which needs to be substantiated in a randomized controlled trial. © 2023 Lippincott Williams and Wilkins. All rights reserved.