ESPN 50th Annual Meeting

ESPN 2017


 
Uric acid, hypertension and carotid intima-media thickness in children with chronic kidney disease
RENATA LOPES 1 ANA LUCIA CARDOSO SANTOS ABREU 1 ANA PAULA BRECHERET 1 FERNANDA LUISA CERAGIOLI OLIVEIRA 1 ALUISIO BARBOSA CARVALHO 1 MARIA CRISTINA ANDRADE 1

1- UNIVERSIDADE FEDERAL DE SãO PAULO -UNIFESP
 
Introduction:

Markers of cardiovascular disease have been associated with increased morbidity and mortality in patients with chronic kidney disease (CDK). Serum uric acid (UA) is related to hypertension and increase the cardiovascular risk. These surrogate markers have been commonly used to study the evolution of cardiovascular disease in children with CKD. The measurement of the intima-media thickness (IMT) has become an additional tool for the early detection of arterial injury and evaluation of cardiovascular risk in these patients. Objective: Evaluate the serum uric acid level, hypertension, the use of allopurinol and its relationship with IMT in patients with CKD. 

 

 

Material and methods:

This cross sectional study included 55 patients (60% males), aged 11.7 years (6.2 – 17.4 years), 43 with non dialysis treatment and 12 on chronic dialysis. Serum levels of UA were obtained for all patients. Hypertension was defined according to the Fourth Report of Blood Pressure in Children as BP>95th percentile or when the patient received anti-hypertensive medications. The IMT were evaluated by ultrasonography by the same examiner and compared with established percentiles for IMT according to gender and height. 

Results:

We found that 25 (45,45%) patients had elevated serum UA, 23 (41,8%) were on allopurinol treatment, 18 (32,7%) were hypertensives and in this group 94% had IMT altered.  In multivariate logistic regression there was a higher chance of elevated IMT in patients who were not on allopurinol treatment (PR=1.32; 95% CI: 1.01; 1.74; p=0.047) and hypertensive patients (PR=1.28; 95% CI: 1.04; 1.58; p=0.023).

Conclusions:

Ours findings suggest that no allopurinol treatment and hypertension were independently associated with increased of IMT. Further studies are needed to elucidated these relations. Close monitoring of blood pressure, treatment of hypertension, monitoring of UA and its treatment with allopurinol are important prevention of cardiovascular disease progression.