Cardiovascular disease as a late complication of end-stage renal disease in children

As in older adults, cardiovascular disease is the most important cause of death in adolescents and young adult patients with end-stage renal disease (ESRD) since childhood. This concerns patients on dialysis as well as transplant patients, despite the fact that a long duration of dialysis during chi...

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Bibliographic Details
Published in:Pediatric nephrology (Berlin, West) West), 2005-03, Vol.20 (3), p.374-379
Main Authors: Groothoff, Jaap W, Lilien, Marc R, van de Kar, Nicole C A J, Wolff, Eric D, Davin, Jean Claude
Format: Article
Language:English
Subjects:
Aortic Valve
Arteries - pathology
Calcification
Calcinosis - etiology
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - etiology
Child
Children
Chronic kidney failure
Complications and side effects
Development and progression
Diagnosis
Diseases
Follow-Up Studies
Heart Valve Diseases - etiology
Hemodialysis
Hospitals
Humans
Hypertension
Kidney diseases
Kidney Failure, Chronic - complications
Mortality
Renal replacement therapy
Risk factors
Time Factors
Young adults
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Summary:As in older adults, cardiovascular disease is the most important cause of death in adolescents and young adult patients with end-stage renal disease (ESRD) since childhood. This concerns patients on dialysis as well as transplant patients, despite the fact that a long duration of dialysis during childhood is an extra mortality risk factor. Left ventricular hypertrophy (LVH), aortic valve calcification, and increased arterial stiffness, but not increased arterial intima media thickening, are the most frequently observed alterations in young adult survivors with childhood ESRD. In transplanted patients a concentric LVH as a result of chronic hypertension is mostly observed; in dialysis patients a more asymmetric septal LVH is found as a result of chronic volume overload. These results suggest that in children and young adults with ESRD chronic pressure and volume overload, a high calcium-phosphate product, and chronic inflammation, but not dyslipidemia, play a role in the development of cardiovascular disease.
ISSN:0931-041X
1432-198X
DOI:10.1007/s00467-004-1624-8