Pulse wave velocity in children and adolescents with chronic kidney disease: a scoping review

Objective . The purpose of the study is to systematize published data to answer the main research question: how often is there an increase in pulse wave velocity (PWV) in children and adolescents with chronic kidney disease (CKD), compared with the control group (and/or reference values adopted in the study)? The study was carried out to show the relevance of further scientific research in this field. Design and methods . The search included PubMed database, the Cochrane Library, the scientific electronic library eLIBRARY.RU, the specialized Pediatric Nephrology journal, the Google Scholar system and the reference lists of relevant articles. Results . Of the 473 identified publications, 35 articles were included in the study. Significant differences were found in the methods for determining PWV (n = 4), devices (n = 9), implementation techniques, and reference values used (n = 4). The mean PWV Z-score in CKD patient groups ranged from –0,13 to 1,89. Among children and adolescents with CKD, the prevalence of PWV ≥ 95th percentile varied from 1% to 61% across studies. In most groups, an increase in PWV was detected in every fifth patient and more often. When compared with the group of healthy children, higher PWV values in patients with CKD were observed in half of the relevant studies (14/25; 56%). Most often, an increase in PWV was determined in children and adolescents with CKD G5 on dialysis therapy, in patients with hypertension, and after kidney transplantation. Conclusions . The majority of children and adolescents with CKD G5 on dialysis therapy have an increased PWV. For patients with CKD G1-G4, the conclusions are mixed, given the significant variability in the results of published studies. There is a need to standardize the measurement of PWV in children and adolescents, to achieve consensus decisions on assessing the results obtained, followed by the implementation of multicenter studies, including the Russian population.