Pediatric nephrology (Berlin, Germany) · 2026
Arterial stiffening in children with early chronic kidney disease is associated with blood pressure but not decline in kidney function: a longitudinal study from the HOT-KID cohort.
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Keehn Louise, Chowienczyk Phil J, Gilbert Rodney, Lunn Andrew, Maxwell Heather, Morgan Henry, Shenoy Mohan, Shroff Rukshana, Subramaniam Pushpa, Tizard Jane, Tse Yincent, Sinha Manish D
Аннотация
BACKGROUND: Children with chronic kidney disease (CKD) are at risk of hypertension and increased arterial stiffness. We examined the roles of blood pressure (BP) and kidney function in development of arterial stiffening in children with early CKD, compared to healthy children.
METHODS: Children who attended for two measurements (mean interval 3.1 ± 1.4 years) of carotid-femoral pulse wave velocity (PWV) as part of the HOT-KID study were included. Annual progression of PWV (PWVAP) was compared for children with CKD (n = 106) versus healthy controls (n = 45), adjusting for mean arterial pressure (MAP) and other risk factors at baseline and follow-up. Multivariable linear regression analyses identified variables significantly associated with PWVAP for each group.
RESULTS: There was no significant difference in PWVAP between children with CKD and those without, when adjusted for key covariates at baseline and follow-up (0.12 ± 0.03 m/s/year and 0.12 ± 0.05 m/s/year respectively, P = 0.977). In healthy controls, PWVAP was independently associated with annual progression of MAP (MAPAP, β = 0.49, P = 0.006), whereas in children with CKD, PWVAP was strongly associated with both baseline MAP and MAPAP (β = 0.26, P = 0.007 and β = 0.53, P < 0.001, respectively) but not baseline or change in estimated glomerular filtration rate.
CONCLUSIONS: These results indicate that there is no demonstrable difference in arterial stiffness between children with early CKD and those without. Renal function in early CKD does not appear to affect arterial stiffening, independent of the BP. The strong association between arterial stiffening and MAP suggests a need for careful BP control in children with CKD.
METHODS: Children who attended for two measurements (mean interval 3.1 ± 1.4 years) of carotid-femoral pulse wave velocity (PWV) as part of the HOT-KID study were included. Annual progression of PWV (PWVAP) was compared for children with CKD (n = 106) versus healthy controls (n = 45), adjusting for mean arterial pressure (MAP) and other risk factors at baseline and follow-up. Multivariable linear regression analyses identified variables significantly associated with PWVAP for each group.
RESULTS: There was no significant difference in PWVAP between children with CKD and those without, when adjusted for key covariates at baseline and follow-up (0.12 ± 0.03 m/s/year and 0.12 ± 0.05 m/s/year respectively, P = 0.977). In healthy controls, PWVAP was independently associated with annual progression of MAP (MAPAP, β = 0.49, P = 0.006), whereas in children with CKD, PWVAP was strongly associated with both baseline MAP and MAPAP (β = 0.26, P = 0.007 and β = 0.53, P < 0.001, respectively) but not baseline or change in estimated glomerular filtration rate.
CONCLUSIONS: These results indicate that there is no demonstrable difference in arterial stiffness between children with early CKD and those without. Renal function in early CKD does not appear to affect arterial stiffening, independent of the BP. The strong association between arterial stiffening and MAP suggests a need for careful BP control in children with CKD.