A federally funded study led by researchers at Johns Hopkins Children's Center has found that children with mild to moderate kidney disease have abnormally thick neck arteries, a condition known as carotid atherosclerosis, usually seen in older adults with a long history of elevated cholesterol and untreated hypertension.
The findings — published online ahead of print on Sept. 13 in the Clinical Journal of the American Society of Nephrology — are particularly striking, the researchers say, because they point to serious blood vessel damage much earlier in the disease process than previously thought. As a result, they add, even children with early-stage kidney disease should be monitored aggressively and treated promptly for both hypertension and high cholesterol to reduce the risk for serious complications down the road.
The researchers caution they are not sure whether the same fatty deposits that clog adult arteries are the reason behind the abnormally thick carotid arteries they observed in the study. But because most of the children involved in the research already had high cholesterol and hypertension — the leading causes of adult atherosclerosis — the investigators believe they are dealing with a disturbingly early onset of this condition in an already vulnerable population.
"Untreated hypertension and high cholesterol increase the risk for long-term vascular damage in any child, but in a child with kidney disease they can wreak much more serious havoc," says study lead investigator Tammy Brady, M.D., M.H.S., a pediatric nephrologist at Hopkins Children's.
Chronic kidney disease by itself increases cardiovascular risk because of chronic inflammation and altered metabolism, the investigators say. But the presence of any additional risk factors — such as obesity, high cholesterol and hypertension — can further fuel that risk and put children with kidney disease on a path to early heart attack and stroke if left untreated, they add.