Cardiovascular phenotypes in children with CKD: The 4C study

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dc.contributor.authorSchaefer F.
dc.contributor.authorDoyon A.
dc.contributor.authorAzukaitis K.
dc.contributor.authorBayazit A.
dc.contributor.authorCanpolat N.
dc.contributor.authorDuzova A.
dc.contributor.authorNiemirska A.
dc.contributor.authorSözeri B.
dc.contributor.authorThurn D.
dc.contributor.authorAnarat A.
dc.contributor.authorRanchin B.
dc.contributor.authorLitwin M.
dc.contributor.authorCaliskan S.
dc.contributor.authorCandan C.
dc.contributor.authorBaskin E.
dc.contributor.authorYilmaz E.
dc.contributor.authorMir S.
dc.contributor.authorKirchner M.
dc.contributor.authorSander A.
dc.contributor.authorHaffner D.
dc.contributor.authorMelk A.
dc.contributor.authorWühl E.
dc.contributor.authorShroff R.
dc.contributor.authorQuerfeld U.
dc.contributor.author4C Study Consortium
dc.date.accessioned2019-10-26T21:16:50Z
dc.date.available2019-10-26T21:16:50Z
dc.date.issued2017
dc.departmentEge Üniversitesien_US
dc.description.abstractBackground and objectives Cardiovascular disease is the most important comorbidity affecting long-term survival in children with CKD. Design, setting, participants, & measurements The Cardiovascular Comorbidity in Children with CKD Study is a multicenter, prospective, observational study in children ages 6–17 years old with initial GFR of 10–60 ml/min per 1.73 m2. The cardiovascular status is monitored annually, and subclinical cardiovascular disease is assessed by noninvasive measurements of surrogate markers, including the left ventricular mass index, carotid intima-media thickness, and central pulse wave velocity. We here report baseline data at study entry and an explorative analysis of variables associated with surrogate markers. Results A total of 737 patients were screened from October of 2009 to August of 2011 in 55 centers in 12 European countries, and baseline data were analyzed in 688 patients. Sixty-four percent had congenital anomalies of the kidney and urinary tract; 26.1% of children had uncontrolled hypertension (24-hour ambulatory BP monitoring; n=545), and the prevalence increased from 24.4% in CKD stage 3 to 47.4% in CKD stage 5. The prevalence of left ventricular hypertrophy was higher with each CKD stage, from 10.6% in CKD stage 3a to 48% in CKD stage 5. Carotid intima-media thickness was elevated in 41.6%, with only 10.8% of patients displaying measurements below the 50th percentile. Pulse wave velocity was increased in 20.1%. The office systolic BP SD score was the single independent factor significantly associated with all surrogate markers of cardiovascular disease. The intermediate end point score (derived from the number of surrogate marker measurements >95th percentile) was independently associated with a diagnosis of congenital anomalies of the kidney and urinary tract, time since diagnosis of CKD, body mass index, office systolic BP, serum phosphorus, and the hemoglobin level. Conclusions The baseline data of this large pediatric cohort show that surrogate markers for cardiovascular disease are closely associated with systolic hypertension and stage of CKD. © 2016 by the American Society of Nephrology.en_US
dc.identifier.doi10.2215/CJN.01090216en_US
dc.identifier.endpage28en_US
dc.identifier.issn1555-9041
dc.identifier.issue1en_US
dc.identifier.pmid27827310en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage19en_US
dc.identifier.urihttps://doi.org/10.2215/CJN.01090216
dc.identifier.urihttps://hdl.handle.net/11454/16264
dc.identifier.volume12en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherAmerican Society of Nephrologyen_US
dc.relation.ispartofClinical Journal of the American Society of Nephrologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectArteriosclerosisen_US
dc.subjectBiomarkersen_US
dc.subjectBlood pressureen_US
dc.subjectBlood pressure monitoring, ambulatoryen_US
dc.subjectBody mass indexen_US
dc.subjectCarotid intima-media thicknessen_US
dc.subjectChilden_US
dc.subjectComorbidityen_US
dc.subjectEurope glomerular filtration rateen_US
dc.subjectHemoglobinsen_US
dc.subjectHumansen_US
dc.subjectHypertensionen_US
dc.subjectHypertrophy, left ventricularen_US
dc.subjectLeft ventricular hypertrophyen_US
dc.subjectPhenotypeen_US
dc.subjectPhosphorusen_US
dc.subjectPhosphorus, dietary prevalenceen_US
dc.subjectProspective studiesen_US
dc.subjectPulse wave analysisen_US
dc.subjectPulse wave velocityen_US
dc.subjectRenal insufficiency, chronic vesico-ureteral refluxen_US
dc.titleCardiovascular phenotypes in children with CKD: The 4C studyen_US
dc.typeArticleen_US

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