Renal size and cardiovascular risk in prepubertal children

Esther Lizarraga-Mollinedo,Silvia Xargay-Torrent,Elena Riera-Pérez,Berta Mas-Pares,Judit Bassols,Abel López-Bermejo,Cristina Padrós-Fornieles,Jose-Maria Martínez-Calcerrada,Gemma Carreras-Badosa,Anna Prats-Puig,Francis De Zegher,Lourdes Ibáñez

doi:10.1038/s41598-019-41757-2

Abstract

Renal size is an important parameter for the evaluation and diagnosis of kidney disease and has been associated with several cardiovascular risk factors in patients with kidney failure. These results are however discordant and studies in healthy children are lacking. We aimed to study the association between renal size (length and volume) and cardiovascular risk parameters in healthy children. Clinical, analytical and ultrasound parameters [renal length, renal volume, perirenal fat and carotid intima-media thickness (cIMT)] were determined in 515 healthy prepubertal children (176 lean, 208 overweight and 131 obese). Renal length and volume associated significantly and positively with several anthropometric and cardiovascular risk parameters including cIMT and systolic blood pressure (SBP) (all p < 0.001). Renal length and volume associated with cIMT and SBP in all study subgroups, but these associations were predominant in obese children, in whom these associations were independent after adjusting for age, gender and BSA (all p < 0.05). In multivariate analyses in the study subjects as a whole, renal length was an independent predictor of cIMT (β = 0.310, p < 0.0001) and SBP (β = 0.116, p = 0.03). Renal size associates with cIMT and SBP, independent of other well-established cardiovascular risk factors, and may represent helpful parameters for the early assessment of cardiovascular risk in children.

Highlights

The kidney plays a central role in the regulation of electrolyte homeostasis and blood pressure and its dysregulation has been associated with several cardiovascular diseases (CVD)[1,2,3]
Several studies have examined the relationship between blood pressure and kidney measurements in different groups of patients[17,18,19,20]; there is a great discrepancy in the results derived from these studies and no investigations have been performed in healthy children. carotid intima-media thickness (cIMT) has been associated with renal function in adults[21,22,23,24] and perirenal fat in children[25]; studies about the association between cIMT and renal size are lacking
Renal length associated with cIMT in all studied subgroups and with systolic blood pressure (SBP) in obese children, while renal volume associate with cIMT and SBP in obese children

Summary

Introduction

The kidney plays a central role in the regulation of electrolyte homeostasis and blood pressure and its dysregulation has been associated with several cardiovascular diseases (CVD)[1,2,3]. Arterial vascular disease, characterized by increased systolic blood pressure and atherosclerosis, are the primary types of CVD present in patients with kidney failure[4]. Renal size may be a marker for the loss of kidney mass and function[8,9], as several authors have described associations between renal volume, nephron mass and kidney disease[10,11,12]. CIMT has been associated with renal function in adults[21,22,23,24] and perirenal fat in children[25]; studies about the association between cIMT and renal size are lacking. Given that there is an accumulating body of evidence suggesting an association between kidney measurements and CVD, and that cardiovascular risk factors may be present in early life, we aimed to study the association

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Conclusion