Abnormal carotid arteries found in children with kidney disease

September 20, 2012

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.

Explore further: Poor growth, delayed puberty and heart problems plague kids with mild kidney disease

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

Related Stories

Poor growth, delayed puberty and heart problems plague kids with mild kidney disease

August 12, 2011
Children with only mildly to moderately impaired kidney function experience poor growth, delays in puberty, and heart problems, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society ...

Complications of chronic kidney disease occur earlier in children

October 4, 2011
(Medical Xpress) -- In what may lead to a shift in treatment, the largest prospective study of children with chronic kidney disease (CKD) has confirmed some experts’ suspicions that complications occur early. The findings ...

Abnormal levels of uric acid in teens linked to high blood pressure

May 1, 2012
Teens with high levels of uric acid appear to be at increased risk for high blood pressure, according to results of research from scientists at the Johns Hopkins Children's Center.

Recommended for you

Investigators may unlock mystery of how staph cells dodge the body's immune system

September 21, 2017
For years, medical investigators have tried and failed to develop vaccines for a type of staph bacteria associated with the deadly superbug MRSA. But a new study by Cedars-Sinai investigators shows how staph cells evade the ...

Superbug's spread to Vietnam threatens malaria control

September 21, 2017
A highly drug resistant malaria 'superbug' from western Cambodia is now present in southern Vietnam, leading to alarming failure rates for dihydroartemisinin (DHA)-piperaquine—Vietnam's national first-line malaria treatment, ...

Individualized diets for irritable bowel syndrome better than placebo

September 21, 2017
Patients with irritable bowel syndrome who follow individualized diets based on food sensitivity testing experience fewer symptoms, say Yale researchers. Their study is among the first to provide scientific evidence for this ...

A dose of 'wait-and-see' reduces unnecessary antibiotic use

September 21, 2017
Asking patients to take a 'wait-and-see' approach before having their antibiotic prescriptions filled significantly reduces unnecessary use, a University of Queensland study has shown.

Groundbreaking investigative effort identifies gonorrhea vaccine candidates

September 19, 2017
Researchers at Oregon State University have identified a pair of proteins that show promise as the basis for a gonorrhea vaccine.

Snail fever progression linked to nitric oxide production

September 14, 2017
Bilharzia, caused by a parasitic worm found in freshwater called Schistosoma, infects around 200 million people globally and its advance can lead to death, especially in children in developing countries.

0 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.