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We examined the roles of blood pressure (BP) and kidney function in development of arterial stiffening in children with early CKD, compared to healthy children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Children who attended for two measurements (mean interval 3.1\u2009\u00b1\u20091.4\u00a0years) of carotid-femoral pulse wave velocity (PWV) as part of the HOT-KID study were included. Annual progression of PWV (PWV\n                      <jats:sub>AP<\/jats:sub>\n                      ) was compared for children with CKD (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009106) versus healthy controls (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200945), adjusting for mean arterial pressure (MAP) and other risk factors at baseline and follow-up. Multivariable linear regression analyses identified variables significantly associated with PWV\n                      <jats:sub>AP<\/jats:sub>\n                      for each group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There was no significant difference in PWV\n                      <jats:sub>AP<\/jats:sub>\n                      between children with CKD and those without, when adjusted for key covariates at baseline and follow-up (0.12\u2009\u00b1\u20090.03\u00a0m\/s\/year and 0.12\u2009\u00b1\u20090.05\u00a0m\/s\/year respectively,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.977). In healthy controls, PWV\n                      <jats:sub>AP<\/jats:sub>\n                      was independently associated with annual progression of MAP (MAP\n                      <jats:sub>AP<\/jats:sub>\n                      ,\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.49,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.006), whereas in children with CKD, PWV\n                      <jats:sub>AP<\/jats:sub>\n                      was strongly associated with both baseline MAP and MAP\n                      <jats:sub>AP<\/jats:sub>\n                      (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.26,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.007 and\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u2009=\u20090.53,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001, respectively) but not baseline or change in estimated glomerular filtration rate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These results indicate that there is no demonstrable difference in arterial stiffness between children with early CKD and those without. Renal function in early CKD does not appear to affect arterial stiffening, independent of the BP. The strong association between arterial stiffening and MAP suggests a need for careful BP control in children with CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                    <jats:p>A higher resolution version of the Graphical abstract is available as Supplementary information.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00467-026-07157-1","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T08:32:48Z","timestamp":1769416368000},"page":"2099-2108","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Arterial stiffening in children with early chronic kidney disease is associated with blood pressure but not decline in kidney function: a longitudinal study from the HOT-KID cohort"],"prefix":"10.1007","volume":"41","author":[{"given":"Louise","family":"Keehn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phil J.","family":"Chowienczyk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney","family":"Gilbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Lunn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Maxwell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohan","family":"Shenoy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rukshana","family":"Shroff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pushpa","family":"Subramaniam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Tizard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yincent","family":"Tse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7593-1203","authenticated-orcid":false,"given":"Manish D.","family":"Sinha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,26]]},"reference":[{"key":"7157_CR1","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1681\/ASN.2011111115","volume":"23","author":"MM Mitsnefes","year":"2012","unstructured":"Mitsnefes MM (2012) Cardiovascular disease in children with chronic kidney disease. 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RDG is on the Data safety monitoring board of Alexion Pharmaceuticals. RS received payments for lectures and support to attend meetings from Fresenius Medical care, Vitaflo and Amgen. RS received grants from Fresenious Medical Care and Vitaflo, and Royalties for Springer text book. RS is on the Fresenious Medical Care Scientific Advisory Board. PJC is the Vice President of British and Irish Hypertension Society.\u00a0LK, AL, HM, HM, MS, PS, JT, YT and MDS declare no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare no competing interests.\u00a0","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}