Journal Article

Increased arterial stiffness in children on haemodialysis

Adrian Covic, Nicoleta Mardare, Paul Gusbeth-Tatomir, Ovidiu Brumaru, Cristina Gavrilovici, Mihaela Munteanu, Octavian Prisada and David J. A. Goldsmith

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 21, issue 3, pages 729-735
Published in print March 2006 | ISSN: 0931-0509
Published online October 2005 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfi196
Increased arterial stiffness in children on haemodialysis

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Background. Measures of aortic stiffness—aortic pulse wave velocity (PWV) and augmentation index (AIx)—have been shown to be powerful predictors of survival in adult haemodialysis (HD) patients. Very few data have been reported regarding arterial stiffness in paediatric renal populations.

Methods. PWV and aortic AIx were determined from contour analysis of arterial waveforms recorded by applanation tonometry using a SphygmoCor device in 14 children on HD (age = 14.1 years) and in 15 age, height matched children controls.

Results. Pre-HD AIx (29.7±15.4%) and PWV (6.6±1.0 m/s) were significantly higher compared with children controls (8.3±8.0% and 5.4±0.6 m/s, respectively, P<0.0001). The only significant difference between normal and HD children was BP level: 103/61 vs 114/72 mmHg, P<0.05. In children of HD patients, a multiple linear regression model including BP, age, height, weight, Ca and P levels as independent variables accounted for 57% of the variability in AIx. Dialysis had no impact on AIx (post-HD: 28.5±12.7%) or on PWV (post-HD: 6.7±0.8 m/s).

Conclusions. We show, in this first-ever report of increased arterial stiffness in children on dialysis, that end-stage renal disease is associated with abnormalities in arterial wall elastic properties, comparable with adult levels, even in childhood. Most importantly, the absence of a discernible amelioration with dialysis implies that purely structural and not functional alterations lie behind the increased arterial stiffness.

Keywords: arterial stiffness; haemodialysis; haemodynamic; intimamedia thickness; paediatric patients

Journal Article.  4898 words. 

Subjects: Nephrology

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