Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2024 May 1;108(5):1212-1219.
doi: 10.1097/TP.0000000000004881. Epub 2024 Apr 24.

Long-term Effects of Kidney Transplantation Compared With Dialysis on Intima-media Thickness in Children-Results From the 4C-T Study

Carl Grabitz  1 , Rizky I Sugianto  1 , Anke Doyon  2 , Karolis Azukaitis  3 , Ali Anarat  4 , Justine Bacchetta  5 , Aysun K Bayazit  4 , Ipek K Bulut  6 , Salim Caliskan  7 , Nur Canpolat  7 , Ali Duzova  8 , Sandra Habbig  9 , Jerome Harambat  10 , Aysel Kiyak  11 , Germana Longo  12 , Lukasz Obrycki  13 , Dusan Paripovic  14 , Oğuz Söylemezoğlu  15 , Daniela Thurn-Valsassina  1 , Alev Yilmaz  16 , Rukshana Shroff  17 , Franz Schaefer  2 , Bernhard M W Schmidt  18 , Anette Melk  1 ; 4C Study Consortium
Collaborators, Affiliations
Comparative Study

Long-term Effects of Kidney Transplantation Compared With Dialysis on Intima-media Thickness in Children-Results From the 4C-T Study

Carl Grabitz et al. Transplantation. .

Abstract

Background: Children requiring kidney replacement therapy experience high burden of cardiovascular (CV) disease leading to increased mortality. Intima-media thickness (IMT) indicating atherosclerosis is a validated surrogate marker for future CV events.

Methods: We investigated the effect of different treatment modalities (dialysis, preemptive kidney transplantation (KTx), late KTx after dialysis) on IMT by multivariable linear mixed-effect modeling. Patients were enrolled in a prospective cohort study.

Results: A total of 261 analyzed children had a mean follow-up of 3 y. Children after preemptive and late KTx had lower levels of IMT when compared with dialysis. Using an interaction term, a significant progression of IMT over time was seen during dialysis (β = 0.0053 mm/y, P = 0.004). IMT before the start of therapy was the most influential determinant in all models. Low IMT was associated with maintenance steroid treatment after preemptive KTx. High IMT on dialysis was associated with higher systolic blood pressure, lower body mass index, lower serum albumin, and lower bicarbonate.

Conclusions: IMT remained rather stable in children several years after KTx. In contrast, children on dialysis had higher IMT values, which increased over time. In these children, blood pressure control, calorie and protein intake, and acid-base homeostasis seem important. Taken together, children might profit from early transplantation to limit accumulation of CV risk.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Harada R, Hamasaki Y, Okuda Y, et al. Epidemiology of pediatric chronic kidney disease/kidney failure: learning from registries and cohort studies. Pediatr Nephrol. 2021;37:1215–1229.
    1. Allen T, Corselli-Nordblad L, Strandell H, et al. In: Brandmüller T, Oennerfors A, eds. Eurostat Regional Yearbook—2020 Edition. Eurostat; 2020.
    1. Bonthuis M, Vidal E, Bjerre A, et al. Ten-year trends in epidemiology and outcomes of pediatric kidney replacement therapy in Europe: data from the ESPN/ERA-EDTA Registry. Pediatr Nephrol. 2021;36:2337–2348.
    1. McDonald SP, Craig JC; Australian and New Zealand Paediatric Nephrology Association. Long-term survival of children with end-stage renal disease. N Engl J Med. 2004;350:2654–2662.
    1. Chavers BM, Molony JT, Solid CA, et al. One-year mortality rates in US children with end-stage renal disease. Am J Nephrol. 2015;41:121–128.

Publication types

LinkOut - more resources