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Open Access 08-05-2024 | Dyslipidemia | Original Article

Dyslipidemia in children with chronic kidney disease—findings from the Cardiovascular Comorbidity in Children with Chronic Kidney Disease (4C) study

Authors: Francesca Mencarelli, Karolis Azukaitis, Marietta Kirchner, Aysun Bayazit, Ali Duzova, Nur Canpolat, Ipek Kaplan Bulut, Lukasz Obrycki, Bruno Ranchin, Rukshana Shroff, Salim Caliskan, Cengiz Candan, Alev Yilmaz, Zeynep Birsin Özcakar, Harika Halpay, Aysel Kiyak, Hakan Erdogan, Jutta Gellermann, Ayse Balat, Anette Melk, Franz Schaefer, Uwe Querfeld

Published in: Pediatric Nephrology

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Abstract

Background

Dyslipidemia is an important and modifiable risk factor for CVD in children with CKD.

Methods

In a cross-sectional study of baseline serum lipid levels in a large prospective cohort study of children with stage 3–5 (predialysis) CKD, frequencies of abnormal lipid levels and types of dyslipidemia were analyzed in the entire cohort and in subpopulations defined by fasting status or by the presence of nephrotic range proteinuria. Associated clinical and laboratory characteristics were determined by multivariable linear regression analysis.

Results

A total of 681 patients aged 12.2 ± 3.3 years with a mean eGFR of 26.9 ± 11.6 ml/min/1.73 m2 were included. Kidney diagnosis was classified as CAKUT in 69%, glomerulopathy in 8.4%, and other disorders in 22.6% of patients. Nephrotic range proteinuria (defined by a urinary albumin/creatinine ratio > 1.1 g/g) was present in 26.9%. Dyslipidemia was found in 71.8%, and high triglyceride (TG) levels were the most common abnormality (54.7%). Fasting status (38.9%) had no effect on dyslipidemia status. Except for a significant increase in TG in more advanced CKD, lipid levels and frequencies of dyslipidemia were not significantly different between CKD stages. Hypertriglyceridemia was associated with younger age, lower eGFR, shorter duration of CKD, higher body mass index (BMI-SDS), lower serum albumin, and higher diastolic blood pressure.

Conclusions

Dyslipidemia involving all lipid fractions, but mainly TG, is present in the majority of patients with CKD irrespective of CKD stage or fasting status and is significantly associated with other cardiovascular risk factors.

Graphical abstract

Appendix
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Metadata
Title
Dyslipidemia in children with chronic kidney disease—findings from the Cardiovascular Comorbidity in Children with Chronic Kidney Disease (4C) study
Authors
Francesca Mencarelli
Karolis Azukaitis
Marietta Kirchner
Aysun Bayazit
Ali Duzova
Nur Canpolat
Ipek Kaplan Bulut
Lukasz Obrycki
Bruno Ranchin
Rukshana Shroff
Salim Caliskan
Cengiz Candan
Alev Yilmaz
Zeynep Birsin Özcakar
Harika Halpay
Aysel Kiyak
Hakan Erdogan
Jutta Gellermann
Ayse Balat
Anette Melk
Franz Schaefer
Uwe Querfeld
Publication date
08-05-2024
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-024-06389-3