Abnormal carotid arteries found in children with kidney disease

A federally funded study led by researchers at Johns Hopkins Children's Center has found that children with mild to moderate kidney disease have abnormally thick neck arteries, a condition known as carotid atherosclerosis, usually seen in older adults with a long history of elevated cholesterol and untreated hypertension.

The findings—published online ahead of print on Sept. 13 in the Clinical Journal of the American Society of Nephrology—are particularly striking, the researchers say, because they point to serious blood vessel damage much earlier in the disease process than previously thought. As a result, they add, even children with early-stage kidney disease should be monitored aggressively and treated promptly for both hypertension and high cholesterol to reduce the risk for serious complications down the road.

The researchers caution they are not sure whether the same that clog adult arteries are the reason behind the abnormally thick carotid arteries they observed in the study. But because most of the children involved in the research already had high cholesterol and hypertension—the leading causes of adult —the investigators believe they are dealing with a disturbingly early onset of this condition in an already vulnerable population.

"Untreated hypertension and high cholesterol increase the risk for long-term in any child, but in a child with kidney disease they can wreak much more serious havoc," says study lead investigator Tammy Brady, M.D., M.H.S., a pediatric nephrologist at Hopkins Children's.

Chronic kidney disease by itself increases because of and altered metabolism, the investigators say. But the presence of any additional risk factors—such as obesity, high cholesterol and hypertension—can further fuel that risk and put children with kidney disease on a path to early heart attack and stroke if left untreated, they add.

In the current multi-center study, which compared 101 children with kidney disease to 97 healthy children, the majority of patients with kidney disease had high blood pressure (87 percent) and elevated cholesterol (55 percent). One-quarter of them were overweight or obese.

Elevated cholesterol and chronically high blood pressure can cause fatty build-up inside the arteries and make them harder and stiffer. A narrowed —the neck vessel that carries blood from the heart to the brain—not only restricts blood flow to the brain but is vulnerable to dangerous fatty plaque ruptures that can lead to heart attacks or strokes.

In their study, researchers performed neck ultrasounds to measure the internal thickness of the carotid artery. On average, children with kidney disease had carotid arteries about 0.02 millimeters thicker than those of children without kidney disease, but some children had arteries up to 0.06 millimeters thicker than their healthy counterparts. High blood pressure and elevated cholesterol increased the difference. Children with hypertension had arteries 0.04 millimeters thicker on average, and children with elevated triglyceride levels had arteries that were 0.05 millimeters thicker.

"We cannot emphasize this enough: Pediatricians who take care of children with chronic kidney disease—even kids with early-stage kidney disease—should screen them early for cardiovascular damage, assess their and treat hypertension and promptly and aggressively," Brady says.

An estimated 20 million Americans have chronic kidney disease, according to the CDC. Because often evolves silently over a period of years, researchers estimate that many adults with late-stage or end-stage kidney disease developed the disease as children.

More information: cjasn.asnjournals.org/content/… 130312.full.pdf+html

Related Stories

Recommended for you

Restrictions lifted at British bird flu farm

9 hours ago

Britain on Sunday lifted all restrictions at a duck farm in northern England after last month's outbreak of H5N8 bird flu, the same strain seen in recent cases across Europe.

Recorded Ebola deaths top 7,000

Dec 20, 2014

The worst Ebola outbreak on record has now killed more than 7,000 people, with many of the latest deaths reported in Sierra Leone, the World Health Organization said as United Nations Secretary-General Ban ...

Liberia holds Senate vote amid Ebola fears (Update)

Dec 20, 2014

Health workers manned polling stations across Liberia on Saturday as voters cast their ballots in a twice-delayed Senate election that has been criticized for its potential to spread the deadly Ebola disease.

Evidence-based recs issued for systemic care in psoriasis

Dec 19, 2014

(HealthDay)—For appropriately selected patients with psoriasis, combining biologics with other systemic treatments, including phototherapy, oral medications, or other biologic, may result in greater efficacy ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.