What Level of Blood Pressure Is Concerning in Childhood?

Circulation Research, Год журнала: 2022, Номер 130(5), С. 800 - 808

Опубликована: Март 3, 2022

The 95th percentile of blood pressure (BP) among healthy children is the currently accepted level used to denote a hypertensive BP reading in pediatric patients. Yet, ample data have emerged showing that detrimental effects high can be demonstrated at levels considered normal by current guidelines. Cardiac, vascular, cognitive, and kidney been shown starting 90th cross-sectional studies, markers adult cardiovascular disease appear longitudinal cohorts whose members had modestly elevated or even as youth. This review summarizes support lower threshold concern for adolescents, outlines some remaining questions answered before could adopted.

Язык: Английский

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Blood Pressure Variability and the Progression of Chronic Kidney Disease: a Systematic Review and Meta-Analysis

Journal of General Internal Medicine, Год журнала: 2023, Номер 38(5), С. 1272 - 1281

Опубликована: Янв. 17, 2023

Язык: Английский

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Chronic kidney disease mineral bone disorder in childhood and young adulthood: a ‘growing’ understanding

Pediatric Nephrology, Год журнала: 2023, Номер 39(3), С. 723 - 739

Опубликована: Авг. 25, 2023

Abstract Chronic kidney disease (CKD) mineral and bone disorder (MBD) comprises a triad of biochemical abnormalities (of calcium, phosphate, parathyroid hormone vitamin D), (turnover, mineralization growth) extra-skeletal calcification. Mineral dysregulation leads to demineralization causing pain an increased fracture risk compared healthy peers. Vascular calcification, with hydroxyapatite deposition in the vessel wall, is part CKD-MBD spectrum and, turn, vascular stiffness, left ventricular hypertrophy very high cardiovascular mortality risk. While growing requires excess calcium can deposit vessels, such that intake calcium- containing medications dialysate need be carefully regulated. Normal physiological continues into third decade life, many years beyond rapid growth childhood adolescence, implying skeletal requirements are much higher younger people elderly. Much research link between (de)mineralization calcification CKD has been performed older adults these data must not extrapolated children or adults. In this article, we explore changes turnover young adults, pathophysiology potential Graphical abstract

Язык: Английский

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Association of Arterial Stiffness With Chronic Kidney Disease Progression and Mortality

Heart Lung and Circulation, Год журнала: 2021, Номер 30(11), С. 1694 - 1701

Опубликована: Сен. 6, 2021

Язык: Английский

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Pulse wave velocity in children and adolescents with chronic kidney disease: a scoping review

Arterial’naya Gipertenziya (Arterial Hypertension), Год журнала: 2025, Номер 30(5), С. 418 - 440

Опубликована: Янв. 21, 2025

Objective . The purpose of the study is to systematize published data answer main research question: how often there an increase in pulse wave velocity (PWV) children and adolescents with chronic kidney disease (CKD), compared control group (and/or reference values adopted study)? was carried out show relevance further scientific this field. Design methods search included PubMed database, Cochrane Library, electronic library eLIBRARY.RU, specialized Pediatric Nephrology journal, Google Scholar system lists relevant articles. Results Of 473 identified publications, 35 articles were study. Significant differences found for determining PWV (n = 4), devices 9), implementation techniques, used 4). mean Z-score CKD patient groups ranged from –0,13 1,89. Among CKD, prevalence ≥ 95th percentile varied 1% 61% across studies. In most groups, detected every fifth more often. When healthy children, higher patients observed half studies (14/25; 56%). Most often, determined G5 on dialysis therapy, hypertension, after transplantation. Conclusions majority therapy have increased PWV. For G1-G4, conclusions are mixed, given significant variability results There a need standardize measurement adolescents, achieve consensus decisions assessing obtained, followed by multicenter studies, including Russian population.

Язык: Английский

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Ultrasound Doppler renal pulsatility index is a predictive marker of arterial stiffness in children with solitary functioning kidney

Brazilian Journal of Nephrology, Год журнала: 2025, Номер 47(2)

Опубликована: Март 11, 2025

Abstract Introduction: Patients with solitary functioning kidney (SFK) have glomerular hyperfiltration, hypertension, proteinuria and impaired renal function resulting in microvascular atherosclerotic abnormalities. This condition leads to an increase arterial stiffness. In this study, we aimed investigate the usefulness of non-invasive Doppler ultrasonography hemodynamic parameters demonstrating stiffness pediatric patients SFK. Methods: The study included 59 children aged 6–18 years who were diagnosed Demographic, biochemical, anthropometric, blood pressure data recorded. ultrasound resistive index (RRI), pulsatility (RPI), carotid-femoral pulse wave velocity (cfPWV), central augmentation (cAIx) carotid intima media thickness (cIMT) evaluated. Results: Eighteen (30.5%) cases acquired SFK 41 (64.5%) congenital detected. Central indices higher than (p = 0.038). CkiD-eGFR-SCr-CysC was lower 0.011). LDL cholesterol levels 0.018). We found a significant correlation between RPI cfPWV coefficient (r) 0.321 statistically p-value 0.013. Conclusions: Congenital is associated increased burden. assessment may be method identify

Язык: Английский

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Índice de pulsatilidade renal por ultrassonografia Doppler como um marcador preditivo de rigidez arterial em crianças com rim solitário funcional

Brazilian Journal of Nephrology, Год журнала: 2025, Номер 47(2)

Опубликована: Март 11, 2025

Resumo Introdução: Pacientes com rim solitário funcional (RSF) apresentam hiperfiltração glomerular, hipertensão, proteinúria e função renal prejudicada, resultando em anormalidades ateroscleróticas microvasculares. Essa condição leva a um aumento na rigidez arterial. Neste estudo, nosso objetivo foi investigar utilidade dos parâmetros hemodinâmicos obtidos por ultrassonografia Doppler não invasiva demonstração da arterial pacientes pediátricos RSF. Métodos: O estudo incluiu 59 crianças idades entre 6 18 anos, diagnosticadas Foram registrados dados demográficos, bioquímicos, antropométricos de pressão avaliados os Doppler, como o índice resistividade (IRR), pulsatilidade (IPR), velocidade onda pulso carotídeo-femoral (VOPcf), amplificação central (cAIx) espessura íntima média carotídea (EIMc). Resultados: detectados (30,5%) casos RSF adquirido 41 (64,5%) congênito. Os índices foram maiores congênito do que naquelas (p = 0,038). CkiD-eGFR-SCr-CysC menor 0,011). níveis colesterol LDL 0,018). Encontramos uma correlação significativa IPR VOPcf coeficiente (r) 0,321 valor p estatisticamente significativo 0,013. Conclusões: está associado ao carga aterosclerótica microvascular. A avaliação pode ser método invasivo para identificar

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Aortic Pulse Wave Velocity and Extracellular Water Expansion in Hemodialysis Patients

Artificial Organs, Год журнала: 2025, Номер unknown

Опубликована: Май 7, 2025

ABSTRACT Background Pulse wave velocity (PWV), a measurement of arterial stiffness, is risk factor for cardiovascular mortality in hemodialysis patients. Debate continues as to whether PWV increased by volume overload. As such, we reviewed the association between overload and PWV. Methods We measured aortic (aPWV) patients attending routine dialysis sessions with contemporaneous measurements extracellular water/total body water (ECW/TBW) ratios using multifrequency bioimpedance. Results A total 102 patients, 63.7% male, mean age 63.5 ± 15.9 years, 44.1% diabetic, median duration 22.2 (4.9–52.8) months, weight 73.7 15.8 kg, central systolic blood pressure 157 35 mmHg had aPWV 10.1 2.5 m/s. Patients dialyzed low dialysate calcium (median 1.0 [1.0–1.25] mmol/L). ≥ 10 m/s were older (72.9 10.3 vs. 52.6 14.4 p < 0.01) higher ECW/TBW ratio (40.6 1.3 39.6 1.7, 0.001), no differences active vitamin D 3 or calcium‐containing medications. Aortic was associated ( r = 0.9, 0.001) 0.33, after adjusting age, remained (40.5 1.5 39.5 1.5, 0.001). On multivariable testing, independently raised (odds [OR] 1.59 (95% confidence intervals [CI] 1.06–2.41), 0.026), adjustment (OR 1.74 CI 1.19–2.53, 0.004)). Conclusions This study highlights overload, determined bioimpedance stiffness aPWV. These results would reinforce importance improving control reduce risk.

Язык: Английский

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Neurologic Disorders Associated With Renal Diseases

Elsevier eBooks, Год журнала: 2025, Номер unknown, С. 1568 - 1579.e5

Опубликована: Июнь 2, 2025

Язык: Английский

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Biomarkers of early detection of heart and vascular damage in children with chronic kidney disease

Nephrology (Saint-Petersburg), Год журнала: 2025, Номер 29(2), С. 17 - 26

Опубликована: Июнь 4, 2025

The article provides an overview of current understanding the risk factors for chronic kidney disease (CKD) and cardiovascular diseases in pediatric population. groups main structural functional markers children with arterial hypertension CKD are considered. results studies confirming their value terms screening, diagnosis, assessment prognosis presented. Differences approaches to use biomarkers adults discussed.

Язык: Английский

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