{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T21:05:48Z","timestamp":1780520748315,"version":"3.54.1"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T00:00:00Z","timestamp":1631577600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Cardiovascular disease (CVD) is a common cause of morbidity and mortality even in young people with chronic kidney disease (CKD). We examined structural and functional CV changes in patients \u02c230 years of age with CKD Stages 4 and 5 and on dialysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A total of 79 children and 21 young adults underwent cardiac computed tomography for coronary artery calcification (CAC), ultrasound for carotid intima-media thickness (cIMT), carotid\u2013femoral pulse wave velocity (cfPWV) and echocardiography. Differences in structural (CAC, cIMT z-score, left ventricular mass index) and functional (carotid distensibility z-score and cfPWV z-score) measures were examined between CKD Stages 4 and 5 and dialysis patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Overall, the cIMT z-score was elevated [median 2.17 (interquartile range 1.14\u20132.86)] and 10 (10%) had CAC. A total of 16\/23 (69.5%) patients with CKD Stages 4 and 5 and 68\/77 (88.3%) on dialysis had at least one structural or functional CV abnormality. There was no difference in the prevalence of structural abnormalities in CKD or dialysis cohorts, but functional abnormalities were more prevalent in patients on dialysis (P &amp;lt; 0.05). The presence of more than one structural abnormality was associated with a 4.5-fold increased odds of more than one functional abnormality (95% confidence interval 1.3\u201316.6; P &amp;lt; 0.05). Patients with structural and functional abnormalities [cIMT z-score &amp;gt;2 standard deviation (SD) or distensibility &amp;lt;\u22122 SD) had less carotid dilatation (lumen:wall cross-sectional area ratio) compared with those with normal cIMT and distensibility.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>There is a high burden of subclinical CVD in young CKD patients, with a greater prevalence of functional abnormalities in dialysis compared with CKD patients. Longitudinal studies are required to test these hypothesis-generating data and define the trajectory of CV changes in CKD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ckj\/sfab168","type":"journal-article","created":{"date-parts":[[2021,9,10]],"date-time":"2021-09-10T03:14:11Z","timestamp":1631243651000},"page":"287-294","source":"Crossref","is-referenced-by-count":13,"title":["The burden of subclinical cardiovascular disease in children and young adults with chronic kidney disease and on dialysis"],"prefix":"10.1093","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5387-3743","authenticated-orcid":false,"given":"Alexander D","family":"Lalayiannis","sequence":"first","affiliation":[{"name":"University College London Great Ormond Street Hospital Institute of Child Health, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0577-7081","authenticated-orcid":false,"given":"Charles J","family":"Ferro","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C","family":"Wheeler","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neill D","family":"Duncan","sequence":"additional","affiliation":[{"name":"Imperial College Renal and Transplant Centre, Hammersmith Hospital, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colette","family":"Smith","sequence":"additional","affiliation":[{"name":"Institute of Global Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce","family":"Popoola","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Transplantation, St. George\u2019s University Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varvara","family":"Askiti","sequence":"additional","affiliation":[{"name":"\u201cP. & A. Kyriakou\u201d Childrens' Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andromachi","family":"Mitsioni","sequence":"additional","affiliation":[{"name":"\u201cP. & A. Kyriakou\u201d Childrens' Hospital, Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amrit","family":"Kaur","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7593-1203","authenticated-orcid":false,"given":"Manish D","family":"Sinha","sequence":"additional","affiliation":[{"name":"Evelina Children\u2019s Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon P","family":"McGuirk","sequence":"additional","affiliation":[{"name":"Birmingham Women\u2019s and Children\u2019s NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian H","family":"Mortensen","sequence":"additional","affiliation":[{"name":"University College London Great Ormond Street Hospital Institute of Child Health, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David V","family":"Milford","sequence":"additional","affiliation":[{"name":"Birmingham Women\u2019s and Children\u2019s NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rukshana","family":"Shroff","sequence":"additional","affiliation":[{"name":"University College London Great Ormond Street Hospital Institute of Child Health, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,9,14]]},"reference":[{"key":"2022032516094294500_sfab168-B1","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1681\/ASN.2011111115","article-title":"Cardiovascular disease in children with chronic kidney disease","volume":"23","author":"Mitsnefes","year":"2012","journal-title":"J Am Soc 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