Interdialytic weight gain and vasculopathy in children on hemodialysis: a single center study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-12

AUTHORS

Vasiliki Karava, Cherine Benzouid, Theresa Kwon, Marie-Alice Macher, Georges Deschênes, Julien Hogan

ABSTRACT

BACKGROUND: Increased interdialytic weight gain (IDWG) has been associated with poor outcomes in adults, but its impact on hemodialysis vasculopathy in children is unknown. METHODS: Nineteen patients (age 9 to 19 years old) with a median hemodialysis duration of 10.4 months were enrolled. Cardiovascular evaluation included left ventricular mass index (LVMI), pulse wave velocity (PWV), and carotid intima-media thickness (cIMT) measurements. PWV and cIMT were expressed as z-scores based on reference values in healthy children. Blood pressure (BP) evaluation consisted in a 24-h ambulatory BP monitoring. Mean IDGW and residual urine output during the 6 months prior to cardiovascular examination were calculated. RESULTS: Increased cIMT, LVMI, and PWV was observed in 11 (57.9%), 7 (36.8%), and 5 (26.3%) patients respectively, while BP was normal in all patients. Median IDWG was 3.5% (1.8-6.7). Residual urine output and BP status did not significantly differ between patients with IDWG ≥ or < 4%. After linear regression, IDWG was correlated to cIMT z-score (r2 = 0.485, p = 0.001), but not to PWV z-score (r2 = 0.04, p = 0.415) and LVMI (r2 = 0.092, p = 0.206). After univariate logistic regression, IDWG ≥ 4% was significantly associated to increased cIMT (above 1.65 SDS) (odds ratio 12.25, 95% confidence interval 1.08-138.988). The trend toward an increased cIMT with IDWG ≥ 4% was observed in both patients with short and long dialysis vintage. CONCLUSIONS: High IDWG is associated with increased cIMT in hemodialyzed children independently of BP control and dialysis vintage. This observation reinforces the importance of interventions to avoid IDWG in hemodialyzed children. More... »

PAGES

2329-2336

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00467-018-4026-z

DOI

http://dx.doi.org/10.1007/s00467-018-4026-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1106526008

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30178237


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    "description": "BACKGROUND: Increased interdialytic weight gain (IDWG) has been associated with poor outcomes in adults, but its impact on hemodialysis vasculopathy in children is unknown.\nMETHODS: Nineteen patients (age 9 to 19\u00a0years old) with a median hemodialysis duration of 10.4\u00a0months were enrolled. Cardiovascular evaluation included left ventricular mass index (LVMI), pulse wave velocity (PWV), and carotid intima-media thickness (cIMT) measurements. PWV and cIMT were expressed as z-scores based on reference values in healthy children. Blood pressure (BP) evaluation consisted in a 24-h ambulatory BP monitoring. Mean IDGW and residual urine output during the 6\u00a0months prior to cardiovascular examination were calculated.\nRESULTS: Increased cIMT, LVMI, and PWV was observed in 11 (57.9%), 7 (36.8%), and 5 (26.3%) patients respectively, while BP was normal in all patients. Median IDWG was 3.5% (1.8-6.7). Residual urine output and BP status did not significantly differ between patients with IDWG \u2265 or <\u20094%. After linear regression, IDWG was correlated to cIMT z-score (r2\u2009=\u20090.485, p\u2009=\u20090.001), but not to PWV z-score (r2\u2009=\u20090.04, p\u2009=\u20090.415) and LVMI (r2\u2009=\u20090.092, p\u2009=\u20090.206). After univariate logistic regression, IDWG \u2265\u20094% was significantly associated to increased cIMT (above 1.65 SDS) (odds ratio 12.25, 95% confidence interval 1.08-138.988). The trend toward an increased cIMT with IDWG \u2265\u20094% was observed in both patients with short and long dialysis vintage.\nCONCLUSIONS: High IDWG is associated with increased cIMT in hemodialyzed children independently of BP control and dialysis vintage. This observation reinforces the importance of interventions to avoid IDWG in hemodialyzed children.", 
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