Prevalence and correlates of multiple cardiovascular risk factors in children with chronic kidney disease

Amy C. Wilson, Michael F. Schneider, Christopher Cox, Larry A. Greenbaum, Jeffrey Saland, Colin T. White, Susan Furth, Bradley A. Warady, Mark M. Mitsnefes

Research output: Contribution to journalArticlepeer-review

Abstract

Background and objectives Although prevalence of traditional cardiovascular risk factors (CVRF) has been described in children with CKD, the frequency with which these CVRF occur concomitantly and the clinical characteristics associated with multiple CVRF are unknown. This study determined the prevalence and characteristics of multiple CVRF in children in the Chronic Kidney Disease in Children study. Design, setting, participants, & measurements Using cross-sectional data from first follow-up visits, we determined the prevalence of four CVRF: hypertension (casual BP >95 th percentile or self-reported hypertension with concurrent use of anti-hypertensive medication), dyslipidemia (triglycerides >130 mg/dl, HDL <40 mg/dl, non-HDL >160 mg/dl, or use of lipid-lowering medication), obesity (BMI >95 th percentile), and abnormal glucose metabolism (fasting glucose >110 mg/dl, insulin >20 μIU/ml, or HOMA-IR >2.20, >3.61, or >3.64 for those at Tanner stage 1, 2 to 3, or 4 to 5, respectively) in 250 children (median age 12.2 years, 74% Caucasian, median iohexol-based GFR 45.2 ml/min per 1.73 m 2). Results Forty-six percent had hypertension, 44% had dyslipidemia, 15% were obese, and 21% had abnormal glucose metabolism. Thirty-nine percent, 22%, and 13% had one, two, and three or more CVRF, respectively. In multivariate ordinal logistic regression analysis, glomerular disease and nephrotic-range proteinuria were associated with 1.96 (95% confidence interval, 1.04 to 3.72) and 2.04 (95% confidence interval, 0.94 to 4.43) higher odds of having more CVRF, respectively. Conclusions We found high prevalence of multiple CVRF in children with mild to moderate CKD. Children with glomerular disease may be at higher risk for future cardiovascular events.

Original languageEnglish (US)
Pages (from-to)2759-2765
Number of pages7
JournalClinical Journal of the American Society of Nephrology
Volume6
Issue number12
DOIs
StatePublished - Dec 1 2011

ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

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