Tain You-Lin, Hsu Chien-Ning
Division of Pediatric Nephrology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Children (Basel). 2022 Oct 28;9(11):1650. doi: 10.3390/children9111650.
Hypertension is the most common complication of chronic kidney disease (CKD) in children, having a strong association with subsequential cardiovascular disease (CVD). In pediatric CKD, a considerable percentage of children with hypertension are undiagnosed or undertreated. Prior research has evaluated structural and functional markers of subclinical CVD and biomarkers in adults with CKD, while ideal biomarkers in pediatrics are still insufficiently studied. The ultimate goal of this review is to summarize what is currently known about state of hypertension, cardiovascular risk factors, and potential CVD markers/biomarkers in children with pre-dialysis CKD. We discuss omics-related biomarkers and the pathophysiologic processes of endothelial dysfunction, kidney injury, oxidative stress and inflammation that are classified by specific biomarkers. Moreover, we illustrate the existing challenges and highlight the paucity of pediatric CKD research to evaluate these CVD biomarkers for future clinical pediatric practice. Thus, achieving clinical utility of CVD biomarkers for use in pediatric CKD remains a significant challenge requiring additional efforts.
高血压是儿童慢性肾脏病（CKD）最常见的并发症，与随后发生的心血管疾病（CVD）密切相关。在儿童CKD中，相当一部分高血压儿童未被诊断或治疗不足。先前的研究评估了CKD成人患者亚临床CVD的结构和功能标志物以及生物标志物，而儿科理想的生物标志物仍研究不足。本综述的最终目标是总结目前关于透析前CKD儿童的高血压状况、心血管危险因素以及潜在CVD标志物/生物标志物的已知情况。我们讨论了与组学相关的生物标志物以及由特定生物标志物分类的内皮功能障碍、肾损伤、氧化应激和炎症的病理生理过程。此外，我们阐述了现有挑战，并强调了儿科CKD研究在评估这些CVD生物标志物以用于未来临床儿科实践方面的不足。因此，实现CVD生物标志物在儿科CKD中的临床应用仍然是一项重大挑战，需要付出更多努力。
