The Cardiovascular Comorbidity in Children with Chronic Kidney Disease (4C) Study: Objectives, Design, and Methodology

被引：114

作者：

Querfeld, Uwe ^{[1
]}

Anarat, All ^{[2
]}

Bayazit, Aysun K. ^{[2
]}

Bakkaloglu, Aysin S. ^{[3
]}

Bilginer, Yelda ^{[3
]}

Caliskan, Salim ^{[4
]}

Civilibal, Mahrnut ^{[4
]}

Doyon, Anke

Duzova, Ali ^{[3
]}

Kracht, Daniela ^{[6
]}

Litwin, Mieczyslaw ^{[7
]}

Melk, Anette ^{[6
]}

Mir, Sevgi ^{[8
]}

Sozeri, Betul ^{[8
]}

Shroff, Rukshana ^{[9
,10
]}

Zeller, Rene ^{[1
]}

Wuehl, Elke

Schaefer, Franz ^{[5
]}

机构：

[1] Charite, Dept Pediat Nephrol, Berlin, Germany

[2] Cukurova Univ, Sch Med, Dept Pediat Nephrol, Adana, Turkey

[3] Hacettepe Univ, Fac Med, Dept Pediat Nephrol, TR-06100 Ankara, Turkey

[4] Istanbul Univ, Cerrahpasa Med Fac, Dept Pediat Nephrol, Istanbul, Turkey

[5] Univ Childrens Hosp Heidelberg, Ctr Pediat & Adolescent Med, Div Pediat Nephrol, D-69120 Heidelberg, Germany

[6] Hannover Med Sch, Dept Pediat Nephrol, Hannover, Germany

[7] Childrens Mem Hlth Inst, Dept Nephrol, Warsaw, Poland

[8] Ege Univ, Fac Med, Dept Pediat Nephrol, Izmir, Turkey

[9] Great Ormond St Hosp Sick Children, Dept Pediat Nephrol, London WC1N 3JH, England

[10] Inst Child Hlth, London, England

来源：

CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2010年 / 5卷 / 09期

关键词：

CHRONIC-RENAL-FAILURE; INTIMA-MEDIA THICKNESS; CORONARY-ARTERY CALCIFICATIONS; LEFT-VENTRICULAR GEOMETRY; YOUNG-ADULTS; PEDIATRIC-PATIENTS; BLOOD-PRESSURE; STIFFNESS; TRANSPLANTATION; PROGRESSION;

D O I：

10.2215/CJN.08791209

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background and objectives: Children and adolescents with chronic kidney disease (CKD) are at high risk for cardiovascular morbidity and mortality. A systemic arteriopathy and cardiomyopathy has been characterized in pediatric dialysis patients by the presence of morphologic and functional abnormalities. Design, setting, participants, & measurements: The Cardiovascular Comorbidity in Children with CKD (4C) Study is a multicenter, prospective, observational study aiming to recruit more than 600 children, aged 6 to 17 years, with initial GFR of 10 to 45 ml/min per 1.73 m(2). The prevalence, degree, and progression of cardiovascular comorbidity as well as its association with CKD progression will be explored through longitudinal follow-up. The morphology and function of the heart and large arteries will be monitored by sensitive noninvasive methods and compared with aged-matched healthy controls. Multiple clinical, anthropometric, biochemical, and pharmacologic risk factors will be monitored prospectively and related to the cardiovascular status. A whole-genome association study will be performed to identify common genetic variants associated with progression of cardiovascular alterations and/or renal failure. Monitoring will be continued as patients reach end-stage renal disease and undergo different renal replacement therapies. Results: While cardiovascular morbidity in adults is related to older age and additional risk factor load (e.g., diabetes), the role of CKD-specific factors in the initiation and progression of cardiac and vascular disease are likely to be characterized with greater sensitivity in the pediatric age group. Conclusions: The 4C study is expected to provide innovative insight into cardiovascular and renal disease progression in CKD. Clin J Am Soc Nephrol 5: 1642-1648, 2010. doi: 10.2215/CJN.08791209

引用

页码：1642 / 1648

页数：7

共 33 条

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