Skip to main content
Top
Published in: Pediatric Nephrology 11/2007

01-11-2007 | Original Article

Evaluation of aortic stiffness in children with chronic renal failure

Authors: Ali Rahmi Bakiler, Onder Yavascan, Nilgun Harputluoglu, Orhan Deniz Kara, Nejat Aksu

Published in: Pediatric Nephrology | Issue 11/2007

Login to get access

Abstract

The measurement of aortic stiffness (As) [aortic strain (S), pressure strain elastic modulus (Ep) and pressure strain normalized by diastolic pressure (Ep*)] is suggested as an excellent marker of subclinical arterial sclerosis. We aimed to investigate the presence of As and to determine the relationship between As and some risk factors in children with chronic renal failure (CRF). Twenty-six pre-dialysis (PreD) [female/male (F/M) 7/19] patients and 23 chronic peritoneal dialysis (CPD) (F/M 13/10) patients were assessed. Twenty-nine healthy children were selected as a control group (F/M 14/15). We determined anemia, abnormal calcium/phosphate metabolism, hypertension, diastolic dysfunction, increased left ventricular mass (LVM), hypertriglyceridemia, increased stiffness (Ep, Ep*), and decreased strain (S) in the CRF (PreD and CPD) group compared with the controls (P < 0.05). Presence of renal disease, LVM and usage of angiotensin-converting enzyme inhibitor (ACE-I) in all groups; female gender, duration of disease and the usage of anti-hypertensive drug therapy in CRF patients; and LVM and LVM index in healthy children were found to be independent predictors for aortic stiffness and/or strain. In conclusion, CRF is associated with significant arterial functional abnormalities in uremic children and not controlled by dialysis treatment. These results suggest that, even in young children, uremia has a profound impact on arterial function.
Literature
1.
go back to reference Aksu N, Yavascan O, Erdogan H, Dorak MC, Kansoy S, Kozan M (1998) Echocardiographic evaluation in children treated with CAPD. Adv Perit Dial 14:255–257PubMed Aksu N, Yavascan O, Erdogan H, Dorak MC, Kansoy S, Kozan M (1998) Echocardiographic evaluation in children treated with CAPD. Adv Perit Dial 14:255–257PubMed
2.
go back to reference Prichard S, Sniderman A, Cianflone K, Marpole D (1996) Cardiovascular disease in peritoneal dialysis. Perit Dial Int 16 [Suppl 1]:S19–S22PubMed Prichard S, Sniderman A, Cianflone K, Marpole D (1996) Cardiovascular disease in peritoneal dialysis. Perit Dial Int 16 [Suppl 1]:S19–S22PubMed
3.
go back to reference Chavers BM, Li S, Collins AJ, Herzog CA (2002) Cardiovascular disease in pediatric chronic dialysis patients. Kidney Int 62:648–653PubMed Chavers BM, Li S, Collins AJ, Herzog CA (2002) Cardiovascular disease in pediatric chronic dialysis patients. Kidney Int 62:648–653PubMed
4.
go back to reference Harnett JD, Kent GM, Barre PE, Taylor R, Parfrey PS (1994) Risk factors for development of left ventricular hypertrophy in a prospectively followed cohort of dialysis patients. J Am Soc Nephrol 4:1486–1490PubMed Harnett JD, Kent GM, Barre PE, Taylor R, Parfrey PS (1994) Risk factors for development of left ventricular hypertrophy in a prospectively followed cohort of dialysis patients. J Am Soc Nephrol 4:1486–1490PubMed
5.
go back to reference Nichols WW, O’Rourke MF (1998) Vascular impedance. In: McDonalds’s blood flow in arteries: theoretical, experimental and clinical principles, 4th edn. Edward Arnold, London, UK, pp 243–293 Nichols WW, O’Rourke MF (1998) Vascular impedance. In: McDonalds’s blood flow in arteries: theoretical, experimental and clinical principles, 4th edn. Edward Arnold, London, UK, pp 243–293
6.
go back to reference Guérin AP, London GM, Marchais SJ, Metivier F (2000) Arterial stiffening and vascular calcifications in end-stage renal disease. Nephrol Dial Transplant 15:1014–1021PubMed Guérin AP, London GM, Marchais SJ, Metivier F (2000) Arterial stiffening and vascular calcifications in end-stage renal disease. Nephrol Dial Transplant 15:1014–1021PubMed
7.
go back to reference Lacombe F, Dart A, Dewar E, Jennings G, Cameron J, Laufer E (1992) Arterial elastic properties in man: a comparison of echo-Doppler indices of aortic stiffness. Eur Heart J 13:1040–1045PubMed Lacombe F, Dart A, Dewar E, Jennings G, Cameron J, Laufer E (1992) Arterial elastic properties in man: a comparison of echo-Doppler indices of aortic stiffness. Eur Heart J 13:1040–1045PubMed
8.
go back to reference Okubo M, Ino T, Takahashi K, Kishiro M, Akimoto K, Yamashiro Y (2001) Age dependency of stiffness of the abdominal aorta and the mechanical properties of the aorta in Kawasaki disease in children. Pediatr Cardiol 22:198–203PubMed Okubo M, Ino T, Takahashi K, Kishiro M, Akimoto K, Yamashiro Y (2001) Age dependency of stiffness of the abdominal aorta and the mechanical properties of the aorta in Kawasaki disease in children. Pediatr Cardiol 22:198–203PubMed
9.
go back to reference Imura T (1985) Non-invasive measurement of the elastic properties of the abdominal aorta and analyses of aging change—changes of elasticity of the aorta by aging. Hokkaido Igaku Zasshi 60:653–661PubMed Imura T (1985) Non-invasive measurement of the elastic properties of the abdominal aorta and analyses of aging change—changes of elasticity of the aorta by aging. Hokkaido Igaku Zasshi 60:653–661PubMed
10.
go back to reference Levent E, Goksen D, Ozyurek AR, Darcan S, Coker M (2002) Stiffness of the abdominal aorta in obese children. J Pediatr Endocrinol Metab 15:405–409PubMed Levent E, Goksen D, Ozyurek AR, Darcan S, Coker M (2002) Stiffness of the abdominal aorta in obese children. J Pediatr Endocrinol Metab 15:405–409PubMed
11.
go back to reference Levent E, Ozyurek AR, Ulger Z (2004) Evaluation of aortic stiffness in tobacco-smoking adolescents. J Adolesc Health 34:339–343PubMed Levent E, Ozyurek AR, Ulger Z (2004) Evaluation of aortic stiffness in tobacco-smoking adolescents. J Adolesc Health 34:339–343PubMed
12.
go back to reference Mitsnefes MM, Kimball TR, Kartal J, Witt SA, Glascock BJ, Khoury PR, Daniels SR (2005) Cardiac and vascular adaptation in pediatric patients with chronic kidney disease: role of calcium–phosphorus metabolism. J Am Soc Nephrol 16:2796–2803PubMed Mitsnefes MM, Kimball TR, Kartal J, Witt SA, Glascock BJ, Khoury PR, Daniels SR (2005) Cardiac and vascular adaptation in pediatric patients with chronic kidney disease: role of calcium–phosphorus metabolism. J Am Soc Nephrol 16:2796–2803PubMed
13.
go back to reference Litwin M, Wuhl E, Jourdan C, Trelewicz J, Niemirska A, Fahr K, Jobs K, Grenda R, Wawer ZT, Rajszys P, Troger J, Mehls O, Schaefer F (2005) Altered morphologic properties of large arteries in children with chronic renal failure and after renal transplantation. J Am Soc Nephrol 16:1494–1500PubMed Litwin M, Wuhl E, Jourdan C, Trelewicz J, Niemirska A, Fahr K, Jobs K, Grenda R, Wawer ZT, Rajszys P, Troger J, Mehls O, Schaefer F (2005) Altered morphologic properties of large arteries in children with chronic renal failure and after renal transplantation. J Am Soc Nephrol 16:1494–1500PubMed
14.
go back to reference Robinson RF, Nahata MC, Sparks E, Daniels C, Batisky DL, Hayes JR, Mahan JD (2005) Abnormal left ventricular mass and aortic strain in pediatric dialysis patients. Pediatr Nephrol 20:64–68PubMed Robinson RF, Nahata MC, Sparks E, Daniels C, Batisky DL, Hayes JR, Mahan JD (2005) Abnormal left ventricular mass and aortic strain in pediatric dialysis patients. Pediatr Nephrol 20:64–68PubMed
15.
go back to reference Groothoff JW, Lilien MR, van de Kar NC, Wolff ED, Davin JC (2005) Cardiovascular disease as a late complication of end-stage renal disease in children. Pediatr Nephrol 20:374–379PubMed Groothoff JW, Lilien MR, van de Kar NC, Wolff ED, Davin JC (2005) Cardiovascular disease as a late complication of end-stage renal disease in children. Pediatr Nephrol 20:374–379PubMed
16.
go back to reference Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, Reichek N (1986) Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy finding. J Am Coll Cardiol 57:450–458 Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, Reichek N (1986) Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy finding. J Am Coll Cardiol 57:450–458
17.
go back to reference De Simone G, Daniels SR, Devereux RB, Meyer RA, Roman MJ, de Divitis O, Alderman MH (1992) Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight. J Am Coll Cardiol 20:1251–1260PubMed De Simone G, Daniels SR, Devereux RB, Meyer RA, Roman MJ, de Divitis O, Alderman MH (1992) Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight. J Am Coll Cardiol 20:1251–1260PubMed
18.
go back to reference Covic A, Gusbeth-Tatomir P, Goldsmith DJA (2005) Arterial stiffness in renal patients: an update. Am J Kidney Dis 45:965–977PubMed Covic A, Gusbeth-Tatomir P, Goldsmith DJA (2005) Arterial stiffness in renal patients: an update. Am J Kidney Dis 45:965–977PubMed
19.
go back to reference Goldsmith DJ, Covic A (2001) Coronary artery disease in uremia: etiology, diagnosis, and therapy. Kidney Int 60:2059–2078PubMed Goldsmith DJ, Covic A (2001) Coronary artery disease in uremia: etiology, diagnosis, and therapy. Kidney Int 60:2059–2078PubMed
20.
go back to reference Toz H, Duman S, Altunel E, Sezis M, Ozbek S, Ozkahya M, Asci G, Ok E, Basci A (2004) Intima media thickness as a predictor of atherosclerosis in renal transplantation. Transplant Proc 36:156–158PubMed Toz H, Duman S, Altunel E, Sezis M, Ozbek S, Ozkahya M, Asci G, Ok E, Basci A (2004) Intima media thickness as a predictor of atherosclerosis in renal transplantation. Transplant Proc 36:156–158PubMed
21.
go back to reference De Simone G, Devereux RB, Daniels SR, Koren MJ, Meyer RA, Laragh JH (1995) Effect of growth on variability of left ventricular mass: assessment of allometric signals in adults and children and their capacity to predict cardiovascular risk. J Am Coll Cardiol 25:1056–1062PubMed De Simone G, Devereux RB, Daniels SR, Koren MJ, Meyer RA, Laragh JH (1995) Effect of growth on variability of left ventricular mass: assessment of allometric signals in adults and children and their capacity to predict cardiovascular risk. J Am Coll Cardiol 25:1056–1062PubMed
22.
go back to reference Blacher J, Pannier B, Guerin AP, Marchais SJ, Safar ME, London GM (1998) Carotid arterial stiffness as a predictor of cardiovascular and all-cause mortality in end-stage renal disease. Hypertension 32:570–574PubMed Blacher J, Pannier B, Guerin AP, Marchais SJ, Safar ME, London GM (1998) Carotid arterial stiffness as a predictor of cardiovascular and all-cause mortality in end-stage renal disease. Hypertension 32:570–574PubMed
23.
go back to reference Barenbrock M, Kosch M, Joster E, Kisters K, Rahn KH, Hausberg M (2002) Reduced arterial distensibility is a predictor of cardiovascular disease in patients after renal transplantation. J Hypertens 20:79–84PubMed Barenbrock M, Kosch M, Joster E, Kisters K, Rahn KH, Hausberg M (2002) Reduced arterial distensibility is a predictor of cardiovascular disease in patients after renal transplantation. J Hypertens 20:79–84PubMed
24.
go back to reference Dijk JM, Algra A, van der GY, Grobbee DE, Bots ML (2005) Carotid stiffness and the risk of new vascular events in patients with manifest cardiovascular disease. The SMART study. Eur Heart J 26:1213–1220PubMed Dijk JM, Algra A, van der GY, Grobbee DE, Bots ML (2005) Carotid stiffness and the risk of new vascular events in patients with manifest cardiovascular disease. The SMART study. Eur Heart J 26:1213–1220PubMed
25.
go back to reference Paini A, Boutouyrie P, Calvet D, Tropeano AI, Laloux B, Laurent S (2006) Carotid and aortic stiffness: determinants of discrepancies. Hypertension 47:371–376PubMed Paini A, Boutouyrie P, Calvet D, Tropeano AI, Laloux B, Laurent S (2006) Carotid and aortic stiffness: determinants of discrepancies. Hypertension 47:371–376PubMed
26.
go back to reference Lakatta EG, Levy D (2003) Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises. Part II. The aging heart in health: links to heart disease. Circulation 107:346–354PubMed Lakatta EG, Levy D (2003) Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises. Part II. The aging heart in health: links to heart disease. Circulation 107:346–354PubMed
27.
go back to reference Groothoff JW, Gruppen MP, Offringa M, Hutten J, Lilien MR, Van De Kar NJ, Wolff ED, Davin JC, Heymans HS (2002) Mortality and causes of death of end-stage renal disease in children: a Dutch cohort study. Kidney Int 61:621–629PubMed Groothoff JW, Gruppen MP, Offringa M, Hutten J, Lilien MR, Van De Kar NJ, Wolff ED, Davin JC, Heymans HS (2002) Mortality and causes of death of end-stage renal disease in children: a Dutch cohort study. Kidney Int 61:621–629PubMed
28.
go back to reference Hayashi T, Nakayama Y, Tsumura K, Yoshimaru K, Ueda H (2002) Reflection in the arterial system and the risk of coronary heart disease. Am J Hypertens 15:405–409PubMed Hayashi T, Nakayama Y, Tsumura K, Yoshimaru K, Ueda H (2002) Reflection in the arterial system and the risk of coronary heart disease. Am J Hypertens 15:405–409PubMed
29.
go back to reference Oh J, Wunsch R, Turzer M, Bahner M, Raggi P, Querfeld U, Mehls O, Schaefer F (2002) Advanced coronary and carotid arteriopathy in young adults with childhood-onset chronic renal failure. Circulation 106:100–105PubMed Oh J, Wunsch R, Turzer M, Bahner M, Raggi P, Querfeld U, Mehls O, Schaefer F (2002) Advanced coronary and carotid arteriopathy in young adults with childhood-onset chronic renal failure. Circulation 106:100–105PubMed
30.
go back to reference Shinohara K, Shoji T, Tsujimoto Y, Kimoto E, Tahara H, Koyama H, Emoto M, Ishimura E, Miki T, Tabata T, Nishizawa Y (2004) Arterial stiffness in predialysis patients with uremia. Kidney Int 65:936–943PubMed Shinohara K, Shoji T, Tsujimoto Y, Kimoto E, Tahara H, Koyama H, Emoto M, Ishimura E, Miki T, Tabata T, Nishizawa Y (2004) Arterial stiffness in predialysis patients with uremia. Kidney Int 65:936–943PubMed
31.
go back to reference Muesing RA, Forman MR, Graubard BI, Beecher GR, Lanza E, McAdam PA, Campbell WS, Olson BR (1996) Cyclic changes in lipoprotein and apolipoprotein levels during the menstrual cycle in healthy premenopausal women on a controlled diet. J Clin Endocrinol Metab 81:3599–3603PubMed Muesing RA, Forman MR, Graubard BI, Beecher GR, Lanza E, McAdam PA, Campbell WS, Olson BR (1996) Cyclic changes in lipoprotein and apolipoprotein levels during the menstrual cycle in healthy premenopausal women on a controlled diet. J Clin Endocrinol Metab 81:3599–3603PubMed
32.
go back to reference Shoji T, Nishizawa Y, Kawagishi T, Kawasaki K, Taniwaki H, Tabata T, Inoue T, Morii H (1998) Intermediate-density lipoprotein as an independent risk factor for aortic atherosclerosis in hemodialysis patients. J Am Soc Nephrol 9:1277–1284PubMed Shoji T, Nishizawa Y, Kawagishi T, Kawasaki K, Taniwaki H, Tabata T, Inoue T, Morii H (1998) Intermediate-density lipoprotein as an independent risk factor for aortic atherosclerosis in hemodialysis patients. J Am Soc Nephrol 9:1277–1284PubMed
33.
go back to reference Covic A, Mardare N, Gusbeth-Tatomir P, Brumaru O, Gavrilovici C, Munteanu M, Prisada O, Goldsmith DJ (2006) Increased arterial stiffness in children on haemodialysis. Nephrol Dial Transplant 21:729–735PubMed Covic A, Mardare N, Gusbeth-Tatomir P, Brumaru O, Gavrilovici C, Munteanu M, Prisada O, Goldsmith DJ (2006) Increased arterial stiffness in children on haemodialysis. Nephrol Dial Transplant 21:729–735PubMed
34.
go back to reference Groothoff JW, Gruppen MP, Offringa M, de Groot E, Stok W, Bos WJ, Davin JC, Lilien MR, Van de Kar NC, Wolff ED, Heymans HS (2002) Increased arterial stiffness in young adults with end-stage renal disease since childhood. J Am Soc Nephrol 13:2953–2961PubMed Groothoff JW, Gruppen MP, Offringa M, de Groot E, Stok W, Bos WJ, Davin JC, Lilien MR, Van de Kar NC, Wolff ED, Heymans HS (2002) Increased arterial stiffness in young adults with end-stage renal disease since childhood. J Am Soc Nephrol 13:2953–2961PubMed
35.
go back to reference London GM, Guerin AP, Marchais SJ, Pannier B, Safar ME, Day M, Metivier F (1996) Cardiac and arterial interactions in end-stage renal disease. Kidney Int 50:600–608PubMed London GM, Guerin AP, Marchais SJ, Pannier B, Safar ME, Day M, Metivier F (1996) Cardiac and arterial interactions in end-stage renal disease. Kidney Int 50:600–608PubMed
36.
go back to reference Barenbrock M, Spieker C, Laske V, Heidenreich S, Hohage H, Bachmann J, Hoeks AP, Rahn KH (1994) Studies of the vessel wall properties in hemodialysis patients. Kidney Int 45:1397–1400PubMed Barenbrock M, Spieker C, Laske V, Heidenreich S, Hohage H, Bachmann J, Hoeks AP, Rahn KH (1994) Studies of the vessel wall properties in hemodialysis patients. Kidney Int 45:1397–1400PubMed
37.
go back to reference Schiffrin EL (2003) Effect of antihypertensive treatment on small artery remodeling in hypertension. Can J Physiol Pharmacol 81:168–176PubMed Schiffrin EL (2003) Effect of antihypertensive treatment on small artery remodeling in hypertension. Can J Physiol Pharmacol 81:168–176PubMed
38.
go back to reference Schiffrin EL (2001) Small artery remodelling in hypertension: can it be corrected? Am J Med Sci 322:7–11PubMed Schiffrin EL (2001) Small artery remodelling in hypertension: can it be corrected? Am J Med Sci 322:7–11PubMed
39.
go back to reference Takami T, Shigematsu M (2003) Effects of calcium channel antagonists on left ventricular hypertrophy and diastolic function in patients with essential hypertension. Clin Exp Hypertens 25:525–535PubMed Takami T, Shigematsu M (2003) Effects of calcium channel antagonists on left ventricular hypertrophy and diastolic function in patients with essential hypertension. Clin Exp Hypertens 25:525–535PubMed
40.
go back to reference Blacher J, Guerin AP, Pannier B, Marchais SJ, London GM (2001) Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease. Hypertension 38:938–942PubMed Blacher J, Guerin AP, Pannier B, Marchais SJ, London GM (2001) Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease. Hypertension 38:938–942PubMed
41.
go back to reference Goodman WG, Goldin J, Kuizon BD, Yoon C, Gales B, Sider D, Wang Y, Chung J, Emerick A, Greaser L, Elashoff RM, Salusky IB (2000) Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 342:1478–1483PubMed Goodman WG, Goldin J, Kuizon BD, Yoon C, Gales B, Sider D, Wang Y, Chung J, Emerick A, Greaser L, Elashoff RM, Salusky IB (2000) Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 342:1478–1483PubMed
42.
go back to reference Rossert J, Froissart M, Jacquot C (2005) Anemia management and chronic renal failure progression. Kidney Int 68 [Suppl 99]:S76–S81 Rossert J, Froissart M, Jacquot C (2005) Anemia management and chronic renal failure progression. Kidney Int 68 [Suppl 99]:S76–S81
43.
go back to reference Ayus JC, Go AS, Valderrabano F, Verde E, de Vinuesa SG, Achinger SG, Lorenzo V, Arieff AI, Luno J; Spanish Group for the Study of the Anemia and Left Ventricular Hypertrophy in Pre-dialysis Patients (2005) Effects of erythropoietin on left ventricular hypertrophy in adults with severe chronic renal failure and hemoglobin < 10 g/dl. Kidney Int 68:788–795PubMed Ayus JC, Go AS, Valderrabano F, Verde E, de Vinuesa SG, Achinger SG, Lorenzo V, Arieff AI, Luno J; Spanish Group for the Study of the Anemia and Left Ventricular Hypertrophy in Pre-dialysis Patients (2005) Effects of erythropoietin on left ventricular hypertrophy in adults with severe chronic renal failure and hemoglobin < 10 g/dl. Kidney Int 68:788–795PubMed
44.
go back to reference Milliner DS, Zinsmelster AR, Lieberman E, Landing B (1990) Soft tissue calcification in pediatric patients with end-stage renal disease. Kidney Int 38:931–936PubMed Milliner DS, Zinsmelster AR, Lieberman E, Landing B (1990) Soft tissue calcification in pediatric patients with end-stage renal disease. Kidney Int 38:931–936PubMed
45.
go back to reference Blacher J, Demuth K, Guerin AP, Safar ME, Moatti N, London GM (1998) Influence of biochemical alterations on arterial stiffness in patients with end-stage renal disease. Arterioscler Thromb Vasc Biol 18:535–541PubMed Blacher J, Demuth K, Guerin AP, Safar ME, Moatti N, London GM (1998) Influence of biochemical alterations on arterial stiffness in patients with end-stage renal disease. Arterioscler Thromb Vasc Biol 18:535–541PubMed
46.
go back to reference Nishizawa Y, Shoji T, Emoto M, Koyama H, Tahara H, Fukumoto S, Inaba M, Ishimura E, Miki T (2004) Roles of metabolic and endocrinological alterations in atherosclerosis and cardiovascular disease in renal failure: another form of metabolic syndrome. Semin Nephrol 24:423–425PubMed Nishizawa Y, Shoji T, Emoto M, Koyama H, Tahara H, Fukumoto S, Inaba M, Ishimura E, Miki T (2004) Roles of metabolic and endocrinological alterations in atherosclerosis and cardiovascular disease in renal failure: another form of metabolic syndrome. Semin Nephrol 24:423–425PubMed
Metadata
Title
Evaluation of aortic stiffness in children with chronic renal failure
Authors
Ali Rahmi Bakiler
Onder Yavascan
Nilgun Harputluoglu
Orhan Deniz Kara
Nejat Aksu
Publication date
01-11-2007
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 11/2007
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-007-0562-7

Other articles of this Issue 11/2007

Pediatric Nephrology 11/2007 Go to the issue