2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) All Versions of this Article: ASN.2006121397v1 18/11/2996    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Shroff, R. C. Articles by Rees, L. Search for Related Content PubMed PubMed Citation Articles by Shroff, R. C. Articles by Rees, L. Related Collections Related Article

Mineral Metabolism and Vascular Damage in Children on Dialysis

Rukshana C. Shroff^*,, Ann E. Donald, Melanie P. Hiorns, Alan Watson, Sally Feather^||, David Milford^¶, Elizabeth A. Ellins, Clare Storry, Deborah Ridout^**, John Deanfield and Lesley Rees^*

Departments of ^* Nephrourology, Vascular Physiology, Radiology, ^** Biostatistics, Great Ormond Street Hospital and Institute of Child Health, London, Nottingham City Hospital, Nottingham, ^|| St. James's University Hospital, Leeds, and ^¶ Birmingham Children's Hospital, Birmingham, United Kingdom

Correspondence: Dr. Rukshana Shroff, Research Registrar, Vascular Physiology Unit, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK. Phone: 0207-4059200, ext. 0065; Fax: 0207-8138532; E-mail: ShrofR{at}gosh.nhs.uk

Received for publication December 23, 2006. Accepted for publication July 2, 2007.

Cardiovascular disease is increasingly recognized as a life-limiting problem in young patients with chronic kidney disease, but there are few studies in children that describe its determinants. We studied the association of intact parathyroid hormone (iPTH) levels and their management on vascular structure and function in 85 children, ages 5–18 years, who had received dialysis for 6 months. Compared to controls, dialysis patients had increased carotid intima-media thickness and pulse-wave velocity. All vascular measures positively correlated with serum phosphorus levels, while carotid intima-media thickness and cardiac calcification score also correlated with iPTH levels. Patients with mean time-integrated iPTH levels less than twice the upper limit of normal (n = 41) had vascular measures that were comparable to age-matched controls, but those with iPTH levels greater than twice the upper limit of normal (n = 44) had greater carotid intima-media thickness, stiffer vessels, and increased cardiac calcification than controls. Patients with increased carotid intima-media thickness had stiffer vessels and a greater prevalence of cardiac calcification. There was a strong dose-dependent correlation between vitamin D and all vascular measures, and calcium intake from phosphate binders weakly correlated with carotid intima-media thickness. In conclusion, both iPTH level and dosage of vitamin D are associated with vascular damage and calcification in children on dialysis.

Related Article

This Month’s Highlights
J. Am. Soc. Nephrol. 2007 18: F3. [Full Text] [PDF]

This article has been cited by other articles:

				R. C. Shroff, R. McNair, N. Figg, J. N. Skepper, L. Schurgers, A. Gupta, M. Hiorns, A. E. Donald, J. Deanfield, L. Rees, et al. Dialysis Accelerates Medial Vascular Calcification in Part by Triggering Smooth Muscle Cell Apoptosis Circulation, October 21, 2008; 118(17): 1748 - 1757. [Abstract] [Full Text] [PDF]

				R. C. Shroff, V. Shah, M. P. Hiorns, M. Schoppet, L. C. Hofbauer, G. Hawa, L. J. Schurgers, A. Singhal, I. Merryweather, P. Brogan, et al. The circulating calcification inhibitors, fetuin-A and osteoprotegerin, but not Matrix Gla protein, are associated with vascular stiffness and calcification in children on dialysis Nephrol. Dial. Transplant., October 1, 2008; 23(10): 3263 - 3271. [Abstract] [Full Text] [PDF]

				R. Shroff, M. Egerton, M. Bridel, V. Shah, A. E. Donald, T. J. Cole, M. P. Hiorns, J. E. Deanfield, and L. Rees A Bimodal Association of Vitamin D Levels and Vascular Disease in Children on Dialysis J. Am. Soc. Nephrol., June 1, 2008; 19(6): 1239 - 1246. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673