Interdialytic weight gain and vasculopathy in children on hemodialysis: a single center study.
Pediatr Nephrol
; 33(12): 2329-2336, 2018 Dec.
Article
em En
| MEDLINE
| ID: mdl-30178237
ABSTRACT
BACKGROUND:
Increased interdialytic weight gain (IDWG) has been associated with poor outcomes in adults, but its impact on hemodialysis vasculopathy in children is unknown.METHODS:
Nineteen patients (age 9 to 19 years old) with a median hemodialysis duration of 10.4 months were enrolled. Cardiovascular evaluation included left ventricular mass index (LVMI), pulse wave velocity (PWV), and carotid intima-media thickness (cIMT) measurements. PWV and cIMT were expressed as z-scores based on reference values in healthy children. Blood pressure (BP) evaluation consisted in a 24-h ambulatory BP monitoring. Mean IDGW and residual urine output during the 6 months prior to cardiovascular examination were calculated.RESULTS:
Increased cIMT, LVMI, and PWV was observed in 11 (57.9%), 7 (36.8%), and 5 (26.3%) patients respectively, while BP was normal in all patients. Median IDWG was 3.5% (1.8-6.7). Residual urine output and BP status did not significantly differ between patients with IDWG ≥ or < 4%. After linear regression, IDWG was correlated to cIMT z-score (r2 = 0.485, p = 0.001), but not to PWV z-score (r2 = 0.04, p = 0.415) and LVMI (r2 = 0.092, p = 0.206). After univariate logistic regression, IDWG ≥ 4% was significantly associated to increased cIMT (above 1.65 SDS) (odds ratio 12.25, 95% confidence interval 1.08-138.988). The trend toward an increased cIMT with IDWG ≥ 4% was observed in both patients with short and long dialysis vintage.CONCLUSIONS:
High IDWG is associated with increased cIMT in hemodialyzed children independently of BP control and dialysis vintage. This observation reinforces the importance of interventions to avoid IDWG in hemodialyzed children.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças Vasculares
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Aumento de Peso
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Diálise Renal
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Espessura Intima-Media Carotídea
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Falência Renal Crônica
Tipo de estudo:
Etiology_studies
/
Observational_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Child
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Female
/
Humans
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Male
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article