Kids With Kidney Disease Face Adult Problem

Carotid atherosclerosis in children with chronic kidney disease

(RxWiki News) Kidney disease can take a toll on your heart and blood vessels. If you add obesity or high blood pressure to the mix, the cardiovascular risk grows even more. Even kids with kidney disease can face very adult complications.

Children with mild to moderate kidney disease may have thicker neck arteries than those without kidney disease.

This condition - called carotid atherosclerosis - usually happens to older adults with a long history of high cholesterol and high blood pressure.

"Kidney disease? Ask for cardiovascular screening."

According to Tammy Brady, MD, MHS, of Johns Hopkins Children's Center, and colleagues, this finding suggests that serious blood vessel damage may happen much earlier in the process of kidney disease than was previously thought.

As such, they say that even children in the early stages of kidney disease should be screened for both high blood pressure and high cholesterol to reduce the risk of future complications.

High cholesterol and high blood pressure (hypertension) can cause fat to build up inside the carotid artery, making it harder and narrower. A narrowed carotid artery can limit blood flow to the brain and raise the risk of heart attack and stroke.

The study by Dr. Brady and colleagues did not show that the fat build-up that clogs adult arteries is the same reason children in the current study had thicker arteries.

However, because most children in the study had high cholesterol and high blood pressure, they may have been experiencing early onset of carotid atherosclerosis.

Kidney disease on its own increases the risk of cardiovascular problems. If a young kidney patient has additional cardiovascular risk factors (e.g. obesity, high cholesterol and high blood pressure), that patient may be faced with heart attack or stroke earlier in life.

In the study, 87 percent of children with kidney disease had high blood pressure, 55 percent had high cholesterol, about about one-quarter were overweight or obese.

Using ultrasound (a technique that uses sound waves to make images of inside the body), Dr. Brady and colleagues measured the internal thickness of patients' carotid artery.

On average, the carotid arteries of children with kidney disease were about 0.02 millimeters thicker than those of healthy children. In some cases, children with kidney disease had carotid arteries that were 0.06 millimeters thicker than those without the disease.

Both high blood pressure and high cholesterol were associated with a greater difference in carotid artery thickness.

On average, children with hypertension had carotid arteries that were 0.04 millimeters thicker. Children with higher cholesterol levels had arteries that were about 0.05 millimeters thicker.

"We cannot emphasize this enough: pediatricians who take care of children with chronic kidney disease — even kids with early-stage kidney disease — should screen them early for cardiovascular damage, assess their risk factors and treat hypertension and high cholesterol promptly and aggressively," said Dr. Brady.

The research included 101 children with kidney disease and 97 without kidney disease.

The study was published in September in the Clinical Journal of the American Society of Nephrology

Review Date: 
September 19, 2012