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Association of pulse pressure, pulse pressure index, and ambulatory arterial stiffness index with kidney function in a cross-sectional pediatric chronic kidney disease cohort from the CKiD study.
Raina, Rupesh; Polaconda, Shyam; Nair, Nikhil; Chakraborty, Ronith; Sethi, Sidharth; Krishnappa, Vinod; Kapur, Gaurav; Mhanna, Maroun; Kusumi, Kirsten.
Afiliação
  • Raina R; Department of Pediatric Nephrology, Akron Children's Hospital, Akron, Ohio, USA.
  • Polaconda S; Akron Nephrology Associates, Cleveland Clinic Akron General, Akron, Ohio, USA.
  • Nair N; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA.
  • Chakraborty R; Department of Chemistry, Case Western Reserve University, Cleveland, Ohio, USA.
  • Sethi S; Akron Nephrology Associates, Cleveland Clinic Akron General, Akron, Ohio, USA.
  • Krishnappa V; Department of Pediatric Nephrology, Medanta, The Medicity, Gurgaon, India.
  • Kapur G; Consortium of Eastern Ohio Master of Public Health student, Northeast Ohio Medical University, Rootstown, Ohio, USA.
  • Mhanna M; Division of Pediatric Nephrology and Hypertension, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, Michigan, USA.
  • Kusumi K; Department of Pediatrics, MetroHealth, Cleveland, Ohio, USA.
J Clin Hypertens (Greenwich) ; 22(6): 1059-1069, 2020 06.
Article em En | MEDLINE | ID: mdl-32472978
The morbidity and mortality of adult and pediatric chronic kidney disease (CKD) and end-stage renal disease (ESRD) populations are mainly driven by cardiovascular disease (CVD). Improving CVD outcomes focuses on risk assessment of factors including diastolic blood pressure (DBP), systolic blood pressure (SBP), left ventricular mass index (LVMI), pulse pressure (PP), and pulse pressure index (PPi), which is calculated as PP/SBP. These markers are also proven predictors of CKD progression; however, their role in children has not been established. This study aims to evaluate the relationship between PP, PPi, ambulatory arterial stiffness index (AASI), and proteinuria with kidney function in pediatric CKD patients; it is a retrospective analysis of 620 patients (1-16 years) from the NIDDK Chronic Kidney Disease in Children (CKiD) registry. The authors analyzed data for three separate cohorts: an overall CKD as well as immunological versus non-immunological cause for CKD groups. An inverse relationship was found between SBP, DBP, and PP with iGFR and LVMI in the overall CKD group. Our immunological CKD subgroup showed significantly higher serum creatinine, SBP, DBP, and PP values with significantly lower serum albumin levels compared to the non-immunological group. There were no significant differences with iohexol-based glomerular filtration rate (iGFR), LVMI, PPi, or high-sensitivity C-reactive protein (hs-CRP) between the two groups. A subgroup analysis demonstrated that SBP, DBP, and PP all correlated significantly with LVMI in the immunological CKD patients but not the non-immunological subgroup. Additionally, AASI data in the overall CKD population were significantly correlated with PP, PPi, and DBP. This study is one of the first to correlate noninvasive measurements of vascular compliance including PP, PPi, and AASI with iGFR and LVMI in a pediatric CKD cohort. Improving our understanding of surrogate markers for early CVD is integral to improving the care of pediatric CKD population as these patients have yet to develop the hard end points of ESRD, heart failure, myocardial infarction, or stroke.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência Renal Crônica / Rigidez Vascular / Hipertensão Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Child / Humans Idioma: En Revista: J Clin Hypertens (Greenwich) Assunto da revista: ANGIOLOGIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Insuficiência Renal Crônica / Rigidez Vascular / Hipertensão Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Child / Humans Idioma: En Revista: J Clin Hypertens (Greenwich) Assunto da revista: ANGIOLOGIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Estados Unidos