Abstract 13138: Very High Resolution Ultrasound Reveals Peripheral Arterial Changes in Both Intima and Media in Children With Chronic Kidney Disease
Background: Children with chronic kidney disease (CKD) have very high cardiovascular morbidity and mortality, and many factors may contribute, including metabolic disturbances and risk factors for atherosclerosis. We hypothesise that widespread intimal and medial changes develop early in CKD children, especially on dialysis.
Methods: Intimal (IT) and medial (MT) thickness of the carotid, radial and dorsal pedal arteries were measured using very high resolution ultrasound (VHRUS) (40-55MHz) in 22 children with CKD (14.6 ± 3.0 years) (n=9 pre-dialysis CKD stages 4-5, n=7 dialysis, n=6 post transplant) and compared to radial and dorsal pedal arteries from 17 matched healthy controls. Results were compared with conventional carotid intima-media thickness (cIMT).
Results: In CKD children, there was widespread medial thickening, which was most marked in dorsal pedal arteries (p=0.001). In children on dialysis, intimal thickening was also seen in radial arteries (p=0.02) and there was a trend for IT in carotid arteries (0.07). Intimal and medial changes could not be distinguished by conventional cIMT.
Conclusion: VHRUS reveals changes of both intima and media, not only in the central, but also in peripheral arteries. These changes are more pronounced in children on dialysis. This suggests that, in CKD children, strategies to target both metabolic and atherosclerosis risk factors should be initiated from an early age.
- © 2013 by American Heart Association, Inc.