Determinants of the intima-media thickness in children and adolescents with chronic kidney disease

Pediatr Nephrol. 2008 May;23(5):805-11. doi: 10.1007/s00467-007-0733-6. Epub 2008 Jan 29.


The aim of the study was to evaluate changes in the arterial wall in children with chronic kidney disease (CKD). We studied 60 patients: 32 with stages 2-4 CKD [chronic renal failure (CRF)], 28 with stage 5 CKD [end-stage renal disease (ESRD)], and 43 controls (C). The evaluated parameters included intima-media thickness (IMT) of the carotid arteries, bone mineral density (BMD), serum lipid levels, and parameters of the calcium-phosphorus metabolism. Patients were divided into two groups: group 1 with normal arteries, and group 2 with arterial changes. The highest serum fetuin A level was found in group 1 compared with groups 2 and C. A negative correlation between IMT and fetuin A level was found. In patients with ESRD, a positive correlation of IMT with phosphorus level and age and a negative correlation with cyclase-activating parathyroid hormone and cyclase inhibiting parathyroid hormone (CAP/CIP) ratio was observed. Multiple linear regression showed that lower fetuin-A and alkaline phosphatase (AP) levels and higher lumbar spine BMD independently predicted higher IMT. Arterial wall changes in children with CKD were related to lower fetuin A and AP level and higher BMD. Low CAP/CIP and high phosphorus level may also be significant factors for arterial changes in patients with ESRD.

Publication types

  • Comparative Study

MeSH terms

  • Absorptiometry, Photon
  • Adolescent
  • Adult
  • Alkaline Phosphatase / blood
  • Blood Proteins / metabolism
  • Bone Density
  • Carotid Arteries / diagnostic imaging*
  • Child
  • Child, Preschool
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / diagnostic imaging*
  • Kidney Failure, Chronic / metabolism
  • Lumbar Vertebrae / diagnostic imaging
  • Male
  • Peripheral Vascular Diseases / diagnostic imaging
  • Peripheral Vascular Diseases / etiology*
  • Peripheral Vascular Diseases / metabolism
  • Phosphorus / metabolism
  • Prognosis
  • Risk Factors
  • Time Factors
  • Tunica Intima / diagnostic imaging*
  • Ultrasonography, Doppler
  • alpha-2-HS-Glycoprotein


  • AHSG protein, human
  • Blood Proteins
  • alpha-2-HS-Glycoprotein
  • Phosphorus
  • Alkaline Phosphatase