Carotid intima–media thickness in children with end-stage renal disease on hemodialysis

Abstract

Objectives: The aim of this study was to study carotid artery intima–media thickness (CIMT) in children with end-stage renal disease who are undergoing hemodialysis. Background: Cardiovascular morbidity and mortality are common in patients with end-stage renal disease. Patients and methods: The study involved 60 children divided into three groups: 20 children had chronic kidney disease on conservative therapy (group I) (predialysis), 20 children were undergoing hemodialysis (group II), and 20 children constituting the control group (group III). All participants were subjected to detailed history taking and clinical examination. Laboratory investigations included evaluation of complete blood picture, serum creatinine, blood urea, calcium (Ca), phosphorus (PO4), uric acid, C-reactive protein, total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, total bilirubin, and albumin. The glomerular filtration rate was calculated from serum creatinine using the Schwartz formula. All participants underwent measurements of CIMT by means of ultrasonography. Results: There was a significant increase in CIMT in group I and group II when each group was compared with group III. CIMT had a significant positive correlation with systolic and diastolic blood pressure, C-reactive protein, serum urea, creatinine, parathyroid hormone, total bilirubin level, and total cholesterol levels. CIMT had a significant negative correlation with BMI, hemoglobin level, hematocrit, estimated glomerular filtration rate, serum calcium, albumin, and high-density lipoprotein levels. Conclusion: Chronic kidney disease is associated with increased CIMT. This suggests that even in young children uremia and/or metabolic alterations have a profound impact on the arterial structure and function leading to cardiovascular morbidity and mortality.