Division of Nephrology, Department of Child Health, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada - Dr Sardjito Hospital, Jl. Farmako Sekip Utara, Yogyakarta, 55281, Indonesia.
Division of Cardiology, Department of Child Health, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada - Dr Sardjito Hospital, Yogyakarta, Indonesia.
BMC Nephrol. 2024 Oct 21;25(1):369. doi: 10.1186/s12882-024-03771-z.
Carotid intima-media thickness (cIMT) is a measure of atherosclerotic vascular disease and a surrogate biomarker for cardiovascular risk in patients with chronic kidney disease (CKD). Mineral and bone disorders (MBD) are complications of CKD, contributing to vascular calcification and accelerated atherosclerosis. Increased fibroblast growth factor 23 (FGF23)-the earliest detectable serum abnormality associated with CKD-MBD-has been linked with cardiovascular disease in patients with CKD. This study aimed to identify factors and analyze the relationship associated with high cIMT, high FGF23, and poor MBD control in children with CKD.
A cross-sectional study was conducted in Yogyakarta, Indonesia recruiting children with CKD. The correlations and factors between cIMT, FGF23, and MBD were explored.
We recruited 42 children aged 2-18 years old with CKD stages 2 to 5D. There were no significant correlations between cIMT and factors including advanced CKD, use of dialysis, body mass index, hypertension, anemia, MBD, FGF23 levels, and left ventricular mass index (LVMI). Patients with advanced CKD had poorly controlled anemia, hypertension, and higher LVMI. In multivariate analysis, CKD stages, hypertension stages, the presence of MBD, and LVMI were associated with FGF23 levels (p < 0.05).
FGF23 levels increased with CKD progression, and MBD was more prevalent in advanced kidney disease. Elevated FGF23 is potentially associated with increased MBD prevalence in late-stage CKD. A larger study is needed to confirm the factors affecting cIMT in children with CKD.
颈动脉内膜-中层厚度（cIMT）是动脉粥样硬化血管疾病的一种衡量指标，也是慢性肾脏病（CKD）患者心血管风险的替代生物标志物。矿物质和骨代谢紊乱（MBD）是 CKD 的并发症，导致血管钙化和动脉粥样硬化加速。成纤维细胞生长因子 23（FGF23）的增加——与 CKD-MBD 相关的最早可检测到的血清异常——与 CKD 患者的心血管疾病有关。本研究旨在确定与 CKD 儿童的高 cIMT、高 FGF23 和 MBD 控制不佳相关的因素并分析其相关性。
在印度尼西亚日惹进行了一项横断面研究，招募了 CKD 儿童。探讨了 cIMT、FGF23 和 MBD 之间的相关性和相关因素。
我们招募了 42 名年龄在 2-18 岁之间的 CKD 患儿，CKD 分期为 2 至 5D。cIMT 与包括晚期 CKD、透析使用、体重指数、高血压、贫血、MBD、FGF23 水平和左心室质量指数（LVMI）在内的因素之间无显著相关性。晚期 CKD 患者贫血、高血压和 LVMI 控制较差。在多变量分析中，CKD 分期、高血压分期、MBD 的存在和 LVMI 与 FGF23 水平相关（p < 0.05）。
FGF23 水平随 CKD 进展而增加，MBD 在晚期肾病中更为常见。升高的 FGF23 可能与晚期 CKD 中 MBD 患病率的增加有关。需要更大的研究来证实影响 CKD 儿童 cIMT 的因素。
