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Dyslipidaemia in children on renal replacement therapy


Bonthuis, M; van Stralen, K J; Jager, K J; Baiko, S (2014). Dyslipidaemia in children on renal replacement therapy. Nephrology, Dialysis, Transplantation, 29(3):594-603.

Abstract

Background: Information on lipid abnormalities in end-stage renal disease (ESRD) mainly originates from adult patients and small paediatric studies. We describe the prevalence of dyslipidaemia, and potential determinants associated with lipid measures in a large cohort of paediatric ESRD patients.
Methods: In the ESPN/ERA-EDTA registry, lipid measurements were available for 976 patients aged 2–17 years from 19 different countries from the year 2000 onwards. Dyslipidaemia was defined as triglycerides >100 mg/dL (2–9 years) or >130 mg/dL (9–17 years), high-density lipoprotein (HDL) cholesterol <40 mg/dL or non-HDL cholesterol >145 mg/dL. Missing data were supplemented using multiple imputation.
Results: The prevalence of dyslipidaemia was 85.1% in peritoneal dialysis (PD) patients, 76.1% in haemodialysis (HD) patients and 55.5% among renal allograft recipients. Both low and high body mass index (BMI) were associated with a less favourable lipid profile. Younger age was associated with a worse lipid profile among PD patients. HDL levels significantly improved after transplantation, whereas no significant improvements were found for triglyceride and non-HDL levels. In transplant recipients, use of cyclosporin was associated with significantly higher non-HDL and HDL levels than tacrolimus usage (P < 0.01). In transplant patients with eGFR < 29 mL/min/1.73 m2, the mean triglyceride level was 137 mg/dL (99% confidence interval (CI): 119–159) compared with 102 mg/dL among those with eGFR > 90 mL/min/1.73 m2 (P < 0.0001).
Conclusions: Dyslipidaemia is common among paediatric ESRD patients in Europe. Young age and PD treatment are associated with worse lipid profiles. Although lipid levels generally improve after transplantation, dyslipidaemia may persist due to decreased graft function, high BMI or to the use of certain immunosuppressants.

Background: Information on lipid abnormalities in end-stage renal disease (ESRD) mainly originates from adult patients and small paediatric studies. We describe the prevalence of dyslipidaemia, and potential determinants associated with lipid measures in a large cohort of paediatric ESRD patients.
Methods: In the ESPN/ERA-EDTA registry, lipid measurements were available for 976 patients aged 2–17 years from 19 different countries from the year 2000 onwards. Dyslipidaemia was defined as triglycerides >100 mg/dL (2–9 years) or >130 mg/dL (9–17 years), high-density lipoprotein (HDL) cholesterol <40 mg/dL or non-HDL cholesterol >145 mg/dL. Missing data were supplemented using multiple imputation.
Results: The prevalence of dyslipidaemia was 85.1% in peritoneal dialysis (PD) patients, 76.1% in haemodialysis (HD) patients and 55.5% among renal allograft recipients. Both low and high body mass index (BMI) were associated with a less favourable lipid profile. Younger age was associated with a worse lipid profile among PD patients. HDL levels significantly improved after transplantation, whereas no significant improvements were found for triglyceride and non-HDL levels. In transplant recipients, use of cyclosporin was associated with significantly higher non-HDL and HDL levels than tacrolimus usage (P < 0.01). In transplant patients with eGFR < 29 mL/min/1.73 m2, the mean triglyceride level was 137 mg/dL (99% confidence interval (CI): 119–159) compared with 102 mg/dL among those with eGFR > 90 mL/min/1.73 m2 (P < 0.0001).
Conclusions: Dyslipidaemia is common among paediatric ESRD patients in Europe. Young age and PD treatment are associated with worse lipid profiles. Although lipid levels generally improve after transplantation, dyslipidaemia may persist due to decreased graft function, high BMI or to the use of certain immunosuppressants.

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2 citations in Web of Science®
1 citation in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:29 March 2014
Deposited On:12 Feb 2015 13:15
Last Modified:05 Apr 2016 18:49
Publisher:Oxford University Press
ISSN:0931-0509
Additional Information:The accepted manuscript is a pre-copyedited, author-produced PDF of an article accepted for publication in NDT following peer review. The definitive publisher-authenticated version Nephrol. Dial. Transplant. (2013) doi: 10.1093/ndt/gft429 is available online at: http://ndt.oxfordjournals.org/content/29/3/594
Publisher DOI:https://doi.org/10.1093/ndt/gft429
Permanent URL: https://doi.org/10.5167/uzh-105083

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