Cardiovascular risk assessment in children with chronic kidney disease

被引:41
作者
Shroff, Rukshana [1 ]
Degi, Arianna [2 ]
Kerti, Andrea [2 ]
Kis, Eva [2 ]
Cseprekal, Orsolya [3 ]
Tory, Kalman [2 ]
Szabo, Attila J. [2 ]
Reusz, George S. [2 ]
机构
[1] Great Ormond St Hosp Sick Children, Renal Unit, London WC1N 3JH, England
[2] Semmelweis Univ, Dept Pediat 1, H-1083 Budapest, Hungary
[3] Semmelweis Univ, Dept Internal Med 1, H-1083 Budapest, Hungary
关键词
Chronic kidney disease; Cardiovascular disease; Carotid intima-media thickness; Pulse wave velocity; Biomarkers; PULSE-WAVE VELOCITY; ARTERIAL STIFFNESS INDEX; STAGE RENAL-DISEASE; INTIMA-MEDIA THICKNESS; HEART-RATE-VARIABILITY; MATRIX GLA PROTEIN; AMBULATORY BLOOD-PRESSURE; GROWTH-FACTOR; 23; VITAMIN-D; YOUNG-ADULTS;
D O I
10.1007/s00467-012-2325-3
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Chronic kidney disease (CKD) is a major factor contributing to cardiovascular (CV) morbidity and mortality with the highest risk in patients on dialysis. An estimation of CV risk is important not only to identify potential modifiable risk factors but also to evaluate the effect of treatments aimed to reduce the risk. Non-invasive methods of measuring vascular changes and circulating biomarkers are available to assess the presence and severity of cardiovascular damage. These include measures of structural (carotid intima-media thickness and coronary artery calcification score) and functional (aortic pulse wave velocity, 24-h ambulatory blood pressure monitoring, ambulatory arterial stiffness index, heart rate variability and flow-mediated dilatation) changes in the vessel wall. In addition, a number of circulating biomarkers of vascular damage and its progression have been studied. Many of these tests are well validated as surrogate markers of future cardiovascular events and death in adult CKD patients, but need technical adaptation, standardization and validation for use in children. With our current state of knowledge, these are best reserved for research studies and scarce clinical resources may be better utilized for preventative strategies to reduce the modifiable risk factors for calcification from early CKD stages.
引用
收藏
页码:875 / 884
页数:10
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