Increased carotid intima-media thickness in African American pediatric kidney transplant recipients

Pediatr Transplant. 2018 May;22(3):e13163. doi: 10.1111/petr.13163. Epub 2018 Feb 8.

Abstract

Early signs of subclinical CV dysfunction can be detected by ultrasound for CIMT. Although A-A are at high risk for CV disease, CIMT of A-A kidney transplant recipients has not been previously investigated. The aim of this prospective, controlled, longitudinal study was to investigate determinants of CIMT in a multiracial pediatric kidney transplant population, with a focus on A-A. Transplant recipients (n = 42) had BMI, waist-to-height ratio, fasting glucose, lipid panel, HbA1c%, and CIMT measured at 1, 18, and 30 months post-transplant. Twenty-four healthy children (14 A-A) served as controls. CIMT of A-A transplant (0.49, 0.49, and 0.48 mm) was higher than non-AA transplant (0.43, 0.44, and 0.44 mm) at 1, 18, and 30 months and higher than A-A controls (0.47 mm). Hyperparathyroidism prior to transplant predicted high CIMT-for-race. A-A race was associated with 10% higher CIMT vs non-A-A transplant. Metabolic syndrome was associated with 0.03 ± 0.01 mm increase in CIMT among A-A transplant recipients only. In conclusion, A-A kidney transplant recipients have increased CIMT. Metabolic syndrome disproportionately affects CIMT of A-A children post-transplant. Identification of subclinical CV damage, detected by CIMT, may provide an opportunity for early detection of CV risk in this vulnerable population.

Keywords: cardiovascular; ethnicity; hyperparathyroidism; metabolic syndrome; obesity.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Atherosclerosis / diagnostic imaging*
  • Atherosclerosis / ethnology
  • Atherosclerosis / etiology
  • Black or African American*
  • Carotid Intima-Media Thickness*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Kidney Transplantation*
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Multivariate Analysis
  • Postoperative Complications / diagnostic imaging*
  • Postoperative Complications / ethnology
  • Postoperative Complications / etiology
  • Prospective Studies
  • Risk Factors
  • Young Adult