Prevalence of Cardiovascular Disease Risk Factors in Childhood Glomerular Diseases

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

卷:8

Jarcy Zee¹  Margaret E. Helmuth¹  Sarah A. Mansfield¹  Amy J. Kogon²  Christine B. Sethna³  Hilda E. Fernandez⁴  Rulan S. Parekh⁵  Donald J. Weaver⁶  Isa F. Ashoor⁷  Michelle M. O'Shaughnessy⁸  Tetyana L. Vasylyeva⁹  Aftab S. Chishti¹⁰  Michelle N. Rheault¹¹  Dorey A. Glenn¹² 

[1] Arbor Research Collaborative for Health Ann Arbor MI;

[2] Children's Hospital of Philadelphia Philadelphia PA;

[3] Cohen Children's Medical Center New York NY;

[4] Columbia University College of Physicians and Surgeons New York NY;

[5] Division of Nephrology Department of Pediatrics and Medicine Hospital for Sick Children University Health Network, and University of Toronto Toronto Canada;

[6] Levine Children's Hospital at Carolinas Medical Center Charlotte NC;

[7] Louisiana State University Health Sciences Center New Orleans LA;

[8] Stanford University School of Medicine Palo Alto CA;

[9] Texas Tech University Health Sciences Center Amarillo TX;

[10] University of Kentucky Lexington KY;

[11] University of Minnesota Masonic Children's Hospital Minneapolis MN;

[12] University of North Carolina at Chapel Hill School of Medicine Chapel Hill NC;

关键词: cardiovascular disease risk factors;    chronic kidney disease;    high blood pressure;    hypercholesterolemia;    hypertension;    pediatrics;   

DOI  :  10.1161/JAHA.119.012143

来源: DOAJ

【 摘 要 】

Background Cardiovascular disease is a major cause of morbidity and mortality in children with chronic kidney disease. We sought to determine the prevalence of cardiovascular risk factors in children with glomerular disease and to describe current practice patterns regarding risk factor identification and management. Methods and Results Seven‐hundred sixty‐one children aged 0 to 17 years with any of 4 biopsy‐confirmed primary glomerular diseases (minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, and IgA nephropathy/vasculitis) were enrolled at a median of 16 months from glomerular disease diagnosis in the multicenter prospective Cure Glomerulonephropathy Network study. Prevalence of traditional (hypertension, hypercholesterolemia, and obesity) and novel (proteinuria, prematurity, and passive smoke exposure) cardiovascular risk factors were determined at enrollment and compared across glomerular disease subtypes. Frequency of screening for dyslipidemia and prescribing of lipid‐lowering or antihypertensive medications were compared across glomerular disease subtype, steroid exposure, and remission status groups. Compared with the general population, all traditional risk factors were more frequent: among those screened, 21% had hypertension, 51% were overweight or obese, and 71% had dyslipidemia. Children who were not in remission at enrollment were more likely to have hypertension and hypercholesterolemia. Fourteen percent of hypertensive children were not receiving antihypertensives. Only 49% underwent screening for dyslipidemia and only 9% of those with confirmed dyslipidemia received lipid‐lowering medications. Conclusions Children with primary glomerular diseases exhibit a high frequency of modifiable cardiovascular risk factors, particularly untreated dyslipidemia. Lipid panels should be routinely measured to better define the burden of dyslipidemia in this population. Current approaches to screening for and treating cardiovascular risk factors are not uniform, highlighting a need for evidence‐based, disease‐specific guidelines.

【 授权许可】

Unknown