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Published in: Pediatric Nephrology 8/2019

01-08-2019 | Dyslipidemia | Original Article

Cardiovascular disease risk among children with focal segmental glomerulosclerosis: a report from the chronic kidney disease in children study

Authors: Christine B. Sethna, Derek K. Ng, Shuai Jiang, Jeff Saland, Bradley A. Warady, Susan Furth, Kevin E. Meyers

Published in: Pediatric Nephrology | Issue 8/2019

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Abstract

Background

The aims were to compare the cardiovascular disease (CVD) risk among children with chronic kidney disease (CKD) secondary to focal segmental glomerulosclerosis (FSGS) with the CVD risk of children with CKD due to other diagnoses.

Methods

Casual blood pressure (BP), ambulatory blood pressure monitoring (APBM), echocardiogram, lipids, carotid intima medial thickness (cIMT), and uric acid obtained from participants in the Chronic Kidney Disease in Children (CKiD) cohort were analyzed longitudinally. Seventy-nine children with FSGS (FSGS-CKD) were compared to 196 children with non-FSGS glomerular disease (GDO-CKD) and 616 children with non-glomerular disease (NG-CKD).

Results

At baseline, FSGS-CKD (median 14 years) had ambulatory hypertension (24.6%), masked hypertension (46.2%), left ventricular hypertrophy (LVH) (26.3%), and dyslipidemia (60.0%). In adjusted models, FSGS-CKD had higher systolic BP z-score (0.52 vs 0.11 and 0.23, p = 0.002 and 0.02), triglycerides (133 vs 109 and 102 mg/dl, p = 0.007 and < 0.001), and non-high density lipoprotein (144 vs 132 and 119 mg/dl, p = 0.07 and < 0.001) at baseline when compared to GDO-CKD and NG-CKD, respectively. Left ventricular mass index (LVMI) (36.0 vs 31.7 g/m2.7, p < 0.001) and the odds of LVH (OR 3.38, 95% CI 1.42, 8.08) at baseline were greater in FSGS-CKD compared to NG-CKD. Adjusted longitudinal analysis showed that FSGS-CKD had a faster decline in LVMI than NG-CKD, and FSGS-CKD had a faster increase in uric acid compared to both groups.

Conclusions

Children with CKD due to FSGS had a relatively high prevalence of CVD risk factors. FSGS was associated with greater CVD risk when compared to other CKD diagnoses.
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Metadata
Title
Cardiovascular disease risk among children with focal segmental glomerulosclerosis: a report from the chronic kidney disease in children study
Authors
Christine B. Sethna
Derek K. Ng
Shuai Jiang
Jeff Saland
Bradley A. Warady
Susan Furth
Kevin E. Meyers
Publication date
01-08-2019
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 8/2019
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-019-04229-3

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