Cardiovascular Risk in Pediatric Renal Transplant Recipients

• Published in: Pediatric transplantation Vol. 28; no. 7; pp. e14831 - n/a
• Main Authors: Hamamoto, Fernando Kazuaki, Carmo Franco, Maria, Jardim, Maria Fernanda Silva, Camargo, Maria Fernanda Carvalho, Nogueira, Paulo C. Koch
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01-11-2024
• Subjects: Adolescent; Biochemical markers; Biomarkers - blood; Calcification (ectopic); cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - etiology; Child; Child, Preschool; Children; chronic renal failure; Computed tomography; Dialysis; Female; Follow-Up Studies; Heart Disease Risk Factors; Humans; Incidence; Kidney diseases; Kidney Transplantation; Kidney transplants; Male; Multivariate Analysis; Pediatrics; Population studies; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Prospective Studies; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - therapy; renalase; Retrospective Studies; Risk Factors; Tomography, X-Ray Computed; cardiovascular disease; renalase; chronic renal failure; kidney transplantation; child
• ISSN: 1397-3142; 1399-3046; 1399-3046
• DOI: 10.1111/petr.14831

ABSTRACT
Background
The survival of pediatric chronic kidney disease (CKD) patients has improved in recent decades due to advances in dialysis and transplantation. However, cardiovascular disease (CVD) emerges as the main cause of mortality in patients with CKD.
Objectives
To estimate cardiovascular risk in children with CKD at least 1 year after kidney transplantation. In addition, the possible association of cardiovascular risk with classic biochemical markers and potential new markers of this outcome was investigated.
Methods
An observational ambidirectional (retrospective capture of risk factors and prospective study of outcomes) research including 75 patients who underwent renal transplant between 2003 and 2013 with postoperative follow‐up of at least 1 year was conducted. The outcome variables adopted were the LV mass Z‐score and the presence of coronary calcification on computed tomography using calcium Agatston score.
Result
Only one patient had an elevated calcium score, and three children (4%) had an LV mass Z‐score ≥ 2.0. After multivariable analysis, only gender, serum triglyceride, and serum renalase concentration remained significantly associated with LV mass.
Conclusion
The low incidence of cardiovascular changes in the population studied confirms the benefit of transplantation for the cardiovascular health of children. Nevertheless, long‐term follow‐up of these patients is recommended, given the limited duration of kidney function provided by transplantation and the high likelihood of further dialysis and kidney transplants being required in these children.
The low incidence of cardiovascular changes in the population studied confirms the benefit of transplantation for the cardiovascular health of children. Only 4% of sample had an LV mass Z‐score ≥ 2.0. After multivariate analysis, only gender, serum triglyceride, and serum renalase concentration remained significantly associated with LV mass.