Schmidt, Bernhard M. W., Sugianto, Rizky Indrameikha ORCID: 0000-0002-7929-507X, Thurn, Daniela, Azukaitis, Karolis, Bayazit, Aysun K., Canpolat, Nur ORCID: 0000-0002-3420-9756, Eroglu, Ayse Guler, Caliskan, Salim ORCID: 0000-0002-3316-8032, Doyon, Anke, Duzova, Ali, Karagoz, Tevfik, Anarat, Ali, Deveci, Murat, Mir, Sevgi, Ranchin, Bruno, Shroff, Rukshana, Baskin, Esra, Litwin, Mieczyslaw ORCID: 0000-0002-5241-2483, Ozcakar, Z. Birsin, Buscher, Rainer, Soylemezoglu, Oguz, Dusek, Jiri, Kemper, Markus J., Matteucci, Maria C., Habbig, Sandra, Laube, Guido, Wuehl, Elke, Querfeld, Uwe, Sander, Anja, Schaefer, Franz and Melk, Anette (2018). Early Effects of Renal Replacement Therapy on Cardiovascular Comorbidity in Children With End-Stage Kidney Disease: Findings From the 4C-T Study. Transplantation, 102 (3). S. 484 - 493. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1534-6080

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Abstract

Background The early impact of renal transplantation on subclinical cardiovascular measures in pediatric patients has not been widely investigated. This analysis is performed for pediatric patients participating in the prospective cardiovascular comorbidity in children with chronic kidney disease study and focuses on the early effects of renal replacement therapy (RRT) modality on cardiovascular comorbidity in patients receiving a preemptive transplant or started on dialysis. Methods We compared measures indicating subclinical cardiovascular organ damage (aortal pulse wave velocity, carotid intima media thickness, left ventricular mass index) and evaluated cardiovascular risk factors in 166 pediatric patients before and 6 to 18 months after start of RRT (n = 76 transplantation, n = 90 dialysis). Results RRT modality had a significant impact on the change in arterial structure and function: compared to dialysis treatment, transplantation was independently associated with decreases in pulse wave velocity (ss = -0.67; P < 0.001) and intima media thickness (ss = -0.40; P = 0.008). Independent of RRT modality, an increase in pulse wave velocity was associated with an increase in diastolic blood pressure (ss = 0.31; P < 0.001). Increasing intima media thickness was associated with a larger increase in body mass index (ss = 0.26; P = 0.003) and the use of antihypertensive agents after RRT (ss = 0.41; P = 0.007). Changes in left ventricular mass index were associated with changes in systolic blood pressure (ss = 1.47; P = 0.01). Conclusions In comparison with initiating dialysis, preemptive transplantation prevented further deterioration of the subclinical vascular organ damage early after transplantation. Classic cardiovascular risk factors, such as hypertension and obesity are of major importance for the development of cardiovascular organ damage after renal transplantation.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Schmidt, Bernhard M. W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sugianto, Rizky IndrameikhaUNSPECIFIEDorcid.org/0000-0002-7929-507XUNSPECIFIED
Thurn, DanielaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Azukaitis, KarolisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bayazit, Aysun K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Canpolat, NurUNSPECIFIEDorcid.org/0000-0002-3420-9756UNSPECIFIED
Eroglu, Ayse GulerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Caliskan, SalimUNSPECIFIEDorcid.org/0000-0002-3316-8032UNSPECIFIED
Doyon, AnkeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Duzova, AliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Karagoz, TevfikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Anarat, AliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Deveci, MuratUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mir, SevgiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ranchin, BrunoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Shroff, RukshanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baskin, EsraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Litwin, MieczyslawUNSPECIFIEDorcid.org/0000-0002-5241-2483UNSPECIFIED
Ozcakar, Z. BirsinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buscher, RainerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Soylemezoglu, OguzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dusek, JiriUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kemper, Markus J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Matteucci, Maria C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Habbig, SandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Laube, GuidoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wuehl, ElkeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Querfeld, UweUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sander, AnjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schaefer, FranzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Melk, AnetteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-195212
DOI: 10.1097/TP.0000000000001948
Journal or Publication Title: Transplantation
Volume: 102
Number: 3
Page Range: S. 484 - 493
Date: 2018
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 1534-6080
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
LEFT-VENTRICULAR MASS; INTIMA-MEDIA THICKNESS; ADOLESCENTS REFERENCE VALUES; CAROTID-ARTERY INTIMA; PULSE-WAVE VELOCITY; MORTALITY RISK; PEDIATRIC-PATIENTS; GRAFT FUNCTION; FOLLOW-UP; HYPERTROPHYMultiple languages
Immunology; Surgery; TransplantationMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/19521

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