Children on haemodialysis had significantly higher pre-dialysis aortic augmentation index (29.7% vs 8.3%) and pulse wave velocity (6.6 vs 5.4 m/s) compared with matched controls (P<0.0001).
Case-Control (n=29)
Does end-stage renal disease requiring haemodialysis increase arterial stiffness in children compared to healthy controls?
Children on haemodialysis exhibit significantly increased arterial stiffness compared to healthy controls, which is not ameliorated by a single dialysis session, suggesting structural rather than functional alterations.
Absolute Event Rate: 29.7% vs 8.3%
p-value: p=<0.0001
BACKGROUND: Measures of aortic stiffness--aortic pulse wave velocity (PWV) and augmentation index (AIx)--have been shown to be powerful predictors of survival in adult haemodialysis (HD) patients. Very few data have been reported regarding arterial stiffness in paediatric renal populations. METHODS: PWV and aortic AIx were determined from contour analysis of arterial waveforms recorded by applanation tonometry using a SphygmoCor device in 14 children on HD (age = 14.1 years) and in 15 age, height matched children controls. RESULTS: Pre-HD AIx (29.7 +/- 15.4%) and PWV (6.6 +/- 1.0 m/s) were significantly higher compared with children controls (8.3 +/- 8.0% and 5.4 +/- 0.6 m/s, respectively, P < 0.0001). The only significant difference between normal and HD children was BP level: 103/61 vs 114/72 mmHg, P < 0.05. In children of HD patients, a multiple linear regression model including BP, age, height, weight, Ca and P levels as independent variables accounted for 57% of the variability in AIx. Dialysis had no impact on AIx (post-HD: 28.5 +/- 12.7%) or on PWV (post-HD: 6.7 +/- 0.8 m/s). CONCLUSIONS: We show, in this first-ever report of increased arterial stiffness in children on dialysis, that end-stage renal disease is associated with abnormalities in arterial wall elastic properties, comparable with adult levels, even in childhood. Most importantly, the absence of a discernible amelioration with dialysis implies that purely structural and not functional alterations lie behind the increased arterial stiffness.
Covic et al. (Wed,) conducted a case-control in End-stage renal disease on haemodialysis (n=29). Haemodialysis (End-stage renal disease) vs. Age and height matched children controls was evaluated on Pre-HD aortic augmentation index (AIx) (p=<0.0001). Children on haemodialysis had significantly higher pre-dialysis aortic augmentation index (29.7% vs 8.3%) and pulse wave velocity (6.6 vs 5.4 m/s) compared with matched controls (P<0.0001).