Long-term Effects of Kidney Transplantation Compared With Dialysis on Intima-media Thickness in Children-Results From the 4C-T Study.

Grabitz, Carl; Sugianto, Rizky I; Doyon, Anke; Azukaitis, Karolis; Anarat, Ali; Bacchetta, Justine; Bayazit, Aysun K; Bulut, Ipek K; Caliskan, Salim; Canpolat, Nur; Duzova, Ali; Harambat, Jerome; Kiyak, Aysel; Longo, Germana; Obrycki, Lukasz; Paripovic, Dusan; Thurn-Valsassina, Daniela; Yilmaz, Alev; Shroff, Rukshana; Schaefer, Franz; ... (2024). Long-term Effects of Kidney Transplantation Compared With Dialysis on Intima-media Thickness in Children-Results From the 4C-T Study. Transplantation, 108(5), pp. 1212-1219. Lippincott Williams & Wilkins 10.1097/TP.0000000000004881

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BACKGROUND

Children requiring kidney replacement therapy experience high burden of cardiovascular (CV) disease leading to increased mortality. Intima-media thickness (IMT) indicating atherosclerosis is a validated surrogate marker for future CV events.

METHODS

We investigated the effect of different treatment modalities (dialysis, preemptive kidney transplantation (KTx), late KTx after dialysis) on IMT by multivariable linear mixed-effect modeling. Patients were enrolled in a prospective cohort study.

RESULTS

A total of 261 analyzed children had a mean follow-up of 3 y. Children after preemptive and late KTx had lower levels of IMT when compared with dialysis. Using an interaction term, a significant progression of IMT over time was seen during dialysis (β = 0.0053 mm/y, P  =  0.004). IMT before the start of therapy was the most influential determinant in all models. Low IMT was associated with maintenance steroid treatment after preemptive KTx. High IMT on dialysis was associated with higher systolic blood pressure, lower body mass index, lower serum albumin, and lower bicarbonate.

CONCLUSIONS

IMT remained rather stable in children several years after KTx. In contrast, children on dialysis had higher IMT values, which increased over time. In these children, blood pressure control, calorie and protein intake, and acid-base homeostasis seem important. Taken together, children might profit from early transplantation to limit accumulation of CV risk.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Nephrology and Hypertension
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Paediatric Nephrology

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1534-6080

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Pubmed Import

Date Deposited:

17 Jan 2024 14:42

Last Modified:

26 Apr 2024 00:13

Publisher DOI:

10.1097/TP.0000000000004881

PubMed ID:

38227773

Additional Information:

Giacomo Simonetti is a collaborator of the 4C Study Consortium.

BORIS DOI:

10.48350/191692

URI:

https://boris.unibe.ch/id/eprint/191692

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