Dr Sarah Marokakis1,2, Dr Siah Kim4,5,6, Dr Anke Raaijmakers8,9, Dr Melanie Wyld3,7, Dr Hugh McCarthy3,4,5
1Sydney Children’s Hospital Network, Sydney, Australia, 2Royal Children’s Hospital, Melbourne, Australia, 3Faculty of Medicine and Health, University of Sydney, Camperdown, Australia, 4Department of Paediatric Nephrology, Children’s Hospital at Westmead, Westmead, Australia, 5Centre for Kidney Research, Westmead, Australia, 6Sydney School of Public Health, University of Sydney, Camperdown, Australia, 7Department of Renal and Transplant Medicine, Westmead Hospital, Westmead, Australia, 8Department of Paediatric Nephrology, Sydney Children’s Hospital, Randwick, Australia, 9School of Women’s and Children’s Health, University of New South Wales, Randwick, Australia
Biography:
I am a Paediatric Nephrology Fellow currently working at Royal Children’s Hospital and previously at Sydney Children’s Hospital Network. I have experience in research in prenatal counselling for congenital anomalies of the kidney and urinary tract, paediatric transplant biopsies and chemotherapy-related kidney disease in children.
Background:
Children with chronic kidney disease (CKD) face a significant lifetime risk of early onset cardiovascular disease (CVD). Screening for risk factors would enable early intervention and improve outcomes.
Aims:
Assess the prevalence of CVD risk factors in children with CKD and evaluate current screening and management practices.
Methods:
In a cross-sectional cohort study of children with CKD stage 4-5 at the Sydney Children’s Hospitals Network, data were extracted from the medical record to assess CVD risk factors assessed including hypertension, dyslipidaemia, diabetes, and body mass index (BMI).
Results:
Eighty-three children (CKD 4: n = 12 (14.5%); CKD 5: n=71 (85.5%)) were included, with a median age of 12 years (IQR 9-16). Eighteen (21.7%) patients had a BMI greater than the 95th centile for age and gender.
Auscultatory blood pressure was measured in 81 (97.6%) patients and 13 (15.7%) patients had 24-hour ambulatory blood pressure monitoring. Forty-two (50.6%) patients were normotensive with 69% of these currently on treatment. Thirty-nine (47%) patients were hypertensive with 48.7% of these currently on treatment. Echocardiography was performed in 42 (51.2%) patients and identified left ventricular hypertrophy in 10 (23.8%) patients.
Lipid studies were performed in 47 (56.6%) patients. Thirty-one (66%) patients had dyslipidaemia, but 30 patients were untreated.
Fasting glucose was measured in 54 (65.1%) patients and elevated in 55.6%. Oral glucose tolerance test was conducted in 2 (2.4%) patients and were normal. HbA1c was measured in 23 (27.7%) patients with one having an elevated level. Three patients were diagnosed with diabetes.
Conclusions:
Cardiovascular risk factors are common in this cohort, yet screening was limited. Implementation of formal screening and intervention could improve long-term cardiovascular health in this population.
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