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Aortic dilatation in children with mild to moderate chronic kidney disease

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A Correction to this article was published on 08 July 2020

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Abstract

Background

Children with mild to moderate chronic kidney disease are at an increased risk for cardiovascular sequelae, the leading cause of death in children with end-stage renal disease. We aimed to establish the prevalence of aortic dilatation, a newly recognized cardiovascular sequelae of renal disease, within a cohort of pediatric patients with mild to moderate kidney disease.

Methods

A total of 501 children enrolled in the Chronic Kidney Disease in Children study contributed imaging data between April 2011 and February 2015. Aortic dilatation was defined as a dimension exceeding a z-score of 2 at any of three locations: aortic root, sinotubular junction, or the ascending aorta.

Results

At baseline echocardiographic evaluation, 30 (6%) children were identified to have aortic dilatation in at least one of the three locations. Multivariate analysis demonstrated an increased odds ratio for the presence of aortic dilatation associated with the following variables: high diastolic blood pressure z-scores, low weight z-score, and low body mass index z-score. Presense of protein energy wasting (modified definition, OR 2.41, 95%CI 1.23, 4.70) was the strongest independent predictor of aortic dilatation.

Conclusion

In conclusion, aortic dilatation does occur early in the course of chronic kidney disease and associates with markers of poor nutrition. Future studies should continue to evaluate these risk factors longitudinally as the kidney disease progresses.

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Change history

  • 08 July 2020

    The original version of this article unfortunately contained a mistake.

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Authors and Affiliations

  1. The Cardiac Center, Nemours Children’s Hospital, 13535 Nemours Parkway, Orlando, FL, 32827, USA

    Peace C. Madueme

  2. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Derek K. Ng

  3. Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Luke Guju, Lauren Longshore, Vicky Moore & Mark Mitsnefes

  4. Methodist University of Tennessee Cardiovascular Institute, Memphis, TN, USA

    Lynn Jefferies

  5. Children’s Mercy Hospital, Kansas City, MO, USA

    Bradley A. Warady

  6. Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Susan Furth

Authors
  1. Peace C. Madueme
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  2. Derek K. Ng
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  3. Luke Guju
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  4. Lauren Longshore
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  5. Vicky Moore
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  6. Lynn Jefferies
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  7. Bradley A. Warady
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  8. Susan Furth
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  9. Mark Mitsnefes
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Correspondence to Peace C. Madueme.

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Madueme, P.C., Ng, D.K., Guju, L. et al. Aortic dilatation in children with mild to moderate chronic kidney disease. Pediatr Nephrol 35, 1023–1031 (2020). https://doi.org/10.1007/s00467-019-04469-3

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  • DOI: https://doi.org/10.1007/s00467-019-04469-3

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