University of Minnesota Masonic Children's Hospital, Minneapolis, Minnesota, USA.
Curr Opin Nephrol Hypertens. 2021 Mar 1;30(2):231-236. doi: 10.1097/MNH.0000000000000684.
Cardiovascular disease (CVD) is a significant cause of morbidity and mortality in children with chronic kidney disease (CKD). The cause of CVD in children with CKD is multifactorial and there are new and emerging data regarding prevalence and risk factors for CVD in this population.
A number of recent publications from longitudinal cohort studies of children with CKD have greatly increased our knowledge about the prevalence and risk factors for CVD including hypertension, obesity and dyslipidaemia. Masked hypertension and isolated nocturnal hypertension both correlate with surrogate markers of CVD in children. Obesity and adiposity are associated with an increased risk of CVD. Markers other than BMI such as waist to height ratio and fat-free tissue to fat tissue ratio better correlate with the presence of CVD in children. Dyslipidaemia is extremely prevalent in the paediatric CKD population, but there is a lack of consensus on treatment. More data on the relationship between bone mineral disease and CVD continue to emerge including an association between hyperparathyroidism and isolated nocturnal hypertension.
Children with CKD have multiple potentially modifiable risk factors for CVD. Research focused on CVD outcomes in children is needed.
心血管疾病（CVD）是慢性肾脏病（CKD）儿童发病率和死亡率的重要原因。CKD 儿童 CVD 的病因是多因素的，关于该人群 CVD 的患病率和危险因素，有新的和新出现的数据。
一些来自 CKD 儿童纵向队列研究的最新出版物极大地增加了我们对 CVD 患病率和危险因素的了解，包括高血压、肥胖和血脂异常。隐匿性高血压和孤立性夜间高血压均与儿童 CVD 的替代标志物相关。肥胖和肥胖症与 CVD 风险增加相关。除 BMI 以外的标志物，如腰高比和去脂组织与脂肪组织比，与儿童 CVD 的存在相关性更好。血脂异常在儿科 CKD 人群中非常普遍，但在治疗方面缺乏共识。关于骨矿物质疾病与 CVD 之间关系的更多数据不断涌现，包括甲状旁腺功能亢进与孤立性夜间高血压之间的关联。
CKD 儿童有多种潜在可改变的 CVD 危险因素。需要对儿童 CVD 结局进行研究。
