Assessment, prevention, and management of cardiovascular disease risk factors in children with chronic kidney disease, on dialysis and after transplantation: clinical practice recommendations from the European Society for Paediatric Nephrology

Abstract

Cardiovascular disease is an important cause of morbidity and the leading cause of death in children with chronic kidney disease. Cardiovascular disease often begins in early chronic kidney disease, progresses rapidly on dialysis, and might only partly attenuate after successful kidney transplantation. Importantly, many cardiovascular disease risk factors are modifiable when detected early and treated appropriately. Despite advances in treatments and dialysis technology, cardiovascular disease continues to cause substantial morbidity and reduced quality of life. Here we present clinical practice points on the assessment, prevention, and management of cardiovascular disease in children with chronic kidney disease, on dialysis, and after transplantation based on the best available evidence and consensus of experts from the European Society for Paediatric Nephrology. Where high-level evidence is lacking, clearly labelled expert opinion is provided and should be adapted to individual patient needs. These guidance points support timely identification and intervention to reduce cardiovascular risk in the paediatric population with chronic kidney disease.