PREDICTORS OF CAROTID INTIMA MEDIA THICKNESS IN OBESE ADOLESCENTS

Our aim was to assess cardiovascular risk factors that may predict increased carotid intima media thickness (cIMT) in obese children and adolescents. Children and adolescents were included in the cross-sectional study if they were aged 9-19 years and had primary obesity. Besides anthropometric and biochemical measurements, ambulatory blood pressure monitoring, measurement of carotid intima media thickness and exercise stress test were performed. We included 103 obese patients and divided them according to the ambulatory blood pressure findings in two groups: obese patients with and without ambulatory hypertension. There were 49 obese patients with and 54 without ambulatory hypertension Univariate analysis showed that there was a significant positive correlation of cIMT with age (r = 0.334, p= 0.001), body mass index (r = 0.288, p = 0.004), waist circumference (r = 0.352, p = 0.000), hip circumference (r = 0.288, p = 0.004), night-time systolic blood pressure (r = 0.226, p = 0.027), and peak diastolic blood pressure on exercise test (r = 0.241, p = 0.018). In a stepwise model, age, waist circumference and peak diastolic blood pressure on exercise test were independent predictors of cIMT

Discontinuation of RAAS Inhibition in Children with Advanced CKD

Background and objectives Although renin-angiotensin-aldosterone system inhibition (RAASi) is a cornerstone in the treatment of children with CKD, it is sometimes discontinued when kidney function declines. We studied the reasons of RAASi discontinuation and associations between RAASi discontinuation and important risk markers of CKD progression and on eGFR decline in the Cardiovascular Comorbidity in Children with CKD study. Design, setting, participants,& measurements In this study, 69 children with CKD(67% male, mean age 13.7 years, mean eGFR 27 ml/min per 1.73m(2)) who discontinued RAASi during prospective follow-up were included. Initial change in BP, albuminuria, and potassium after discontinuation were assessed (median time 6 months). Rate of eGFR decline (eGFR slope) during a median of 1.9 years before and 1.2 years after discontinuation were estimated using linear mixed effects modeling. Results Physician-reported reasons for RAASi discontinuation were increase in serum creatinine, hyperkalemia, and symptomatic hypotension. After discontinuation of RAASi, BP and albuminuria increased, whereas potassium decreased. eGFR declined more rapidly after discontinuation of RAASi (23.9 ml/min per 1.73m2 per year; 95% confidence interval, 25.1 to 22.6) compared with the slope during RAASi treatment (21.5 ml/min per 1.73 m(2) per year; 95% confidence interval, 22.4 to 20.6; P=0.005). In contrast, no change in eGFR slope was observed in a matched control cohort of patients in whom RAASi was continued. Conclusions Discontinuation of RAASi in children with CKD is associated with an acceleration of kidney function decline, even in advanced CKD

PREDICTORS OF CAROTID INTIMA MEDIA THICKNESS IN OBESE ADOLESCENTS

Our aim was to assess cardiovascular risk factors that may predict increased carotid intima media thickness (cIMT) in obese children and adolescents. Children and adolescents were included in the cross-sectional study if they were aged 9-19 years and had primary obesity. Besides anthropometric and biochemical measurements, ambulatory blood pressure monitoring, measurement of carotid intima media thickness and exercise stress test were performed. We included 103 obese patients and divided them according to the ambulatory blood pressure findings in two groups: obese patients with and without ambulatory hypertension. There were 49 obese patients with and 54 without ambulatory hypertension Univariate analysis showed that there was a significant positive correlation of cIMT with age (r = 0.334, p= 0.001), body mass index (r = 0.288, p = 0.004), waist circumference (r = 0.352, p = 0.000), hip circumference (r = 0.288, p = 0.004), night-time systolic blood pressure (r = 0.226, p = 0.027), and peak diastolic blood pressure on exercise test (r = 0.241, p = 0.018). In a stepwise model, age, waist circumference and peak diastolic blood pressure on exercise test were independent predictors of cIMT

PEPTIDE BIOMARKER SIGNATURES IN STEROID-RESISTANT NEPHROTIC SYNDROME

55th Congress of the European-Renal-Association (ERA) and European-Dialysis-and-Transplantation-Association (EDTA) -- MAY 24-27, 2018 -- Copenhagen, DENMARKWOS: 000433059802143…European Renal Assoc, European Dialysis & Transplant Asso