Arterial Stiffness in Children with Early Chronic Kidney Disease: A Longitudinal Study Reveals Similar Rates to Healthy Peers

Children with early chronic kidney disease (CKD) experience arterial stiffening at rates comparable to their healthy peers, with higher mean arterial pressure (MAP) linked to worsening vascular stiffness over time, according to findings from a longitudinal study of the HOT-KID cohort. Researchers investigated the roles of blood pressure (BP) and kidney function in the development of arterial stiffening among children with CKD.

Study Details and Participants

Louise Keehn, MSc, of King’s College London, England, and colleagues analyzed data from 106 children with CKD and 45 healthy controls who underwent two measurements of carotid–femoral pulse wave velocity (PWV), approximately 3 years apart [1]. Participants ranged in age from 3 to 10 years and had stage 1-3 CKD. The most common cause of CKD in the study population was congenital anomalies of the kidney and urinary tract, affecting 61% of the children [1].

Key Findings

At the start of the study, the average estimated glomerular filtration rate (eGFR) for children with CKD was 85 mL/min/1.73 m². There were no significant differences in demographic characteristics or vascular measurements between the CKD and control groups [1].

The study revealed no significant difference in the annual progression of PWV (PWVAP) between children with CKD and the control group after adjusting for key factors (P=0.977). PWV increased by 0.26±0.8 m/s in the healthy control group and by 0.32±0.89 m/s in the CKD group [1]. There were also no significant differences in annual gains in height or weight between the groups.

During the study period, eGFR declined from 83±29 mL/min/1.73 m² to 75±30 mL/min/1.73 m² among children with CKD [1].

Blood Pressure’s Role in Arterial Stiffening

PWVAP was independently associated with the annual progression of MAP in the control group. However, in children with CKD, PWVAP was strongly associated with both baseline MAP and the annual progression of MAP [1]. Notably, renal function did not appear to affect arterial stiffening independently of blood pressure.

Implications for Pediatric CKD Management

“The strong association between arterial stiffening and MAP suggests a need for careful BP control in children with CKD,” the researchers concluded [1]. These findings emphasize the importance of monitoring and managing blood pressure in children with early CKD to mitigate potential cardiovascular risks.

About the HOT-KID Cohort

The study was conducted as part of the HOT-KID study, a longitudinal investigation into kidney health in children [3].