ESPN 51th Annual Meeting

ESPN 2018


 
Body composition and arterial stiffness in children with chronic kidney disease
VASILIKI KARAVA 1 STELLA STABOULI 1 NIKOLETA PRINTZA 1 JOHN DOTIS 1 CHRISA GOGA 1 AGGELIKI APOSTOLOU 1 DESPOINA DEMERTZI 1 NIKOLETA CHATZIPAPA 1 FOTIOS PAPACHRISTOU 1

1- 1ST DEPARTMENT OF PEDIATRICS, HIPPOKRATION GENERAL HOSPITAL, ARISTOTLE UNIVERSITY, THESSALONIKI, GREECE
 
Introduction:

Cardiovascular disease represents the most common complication of chronic kidney disease (CKD). This study aims to investigate the relation of anthropometric parameters with arterial stifness.

Material and methods:

The study population consisted of 26 patients (8-17 years old) with glomerular filtration rate <80ml/min /1.73m² and 25 healthy controls with same age. Fat tissue index (FTI) and lean tissue index (LTI) were measured with bioelectrical impedance analysis (BIA). Arterial stiffness was assessed by carotid femoral pulse wave velocity (PWV) measurement. FTI, LTI, body mass index (BMI) and PWV z-scores were calculated based on reference values for healthy children of  same age. Blood pressure (BP) status was assessed by systolic (SBP) and diastolic BP (DBP) measurement and by need for antihypertensive treatment.

 

Results:

BMI and LTI z-score, but not FTI z-score, were significantly lower in patients with CKD compared to healthy controls (p=0.037, p=0.003 and p=0.216 respectively). A significant linear correlation was observed between LTI z-score and FTI z-score in healthy controls (r²=0.508, p=0.009) but not in CKD patients (r²=0.283, p=0.161). FTI z-score was the only anthropometric parameter significantly lower in patients with CKD stage 4 and 5 (p=0.05). A quadratic correlation was observed between BMI, FTI, LTI z-scores and PWV z-score (r²=0.334 and p=0.009, r²=0.335 and p=0.009, r²=0.276 and p=0.024 respectively). In univariate logistic regression analysis, FTI, LTI and BMI z-scores, but not BP status, were significantly associated to the risk for PWV z-score>2 SDS (OR 7.048, 4.995 and 6.421 respectively). In multiple logistic regression analysis, BMI z-score was the only significant factor of increased PWV (p=0.014). 

Conclusions:

Both underweight and overweight are correlated to arterial stifness in children with CKD. Both high FTI and LTI are correlated to arterial stifness, regardless BP status. BMI represents the finest anthropometric parameter of cardiovascular risk.