Dyslipidemia in children with chronic kidney disease

Abstract

Dyslipidemia, a known risk factor for atherosclerosis, is frequent among both adults and children with chronic kidney disease. Here, we describe the prevalence and pattern of dyslipidemia from a cross-sectional analysis of 391 children aged 1-16 years, enrolled in the multicenter Chronic Kidney Disease in Children (CKiD) study, with a median glomerular filtration rate (GFR), measured by the plasma disappearance of iohexol, of 43 ml/min per 1.73 m2. Multivariate analysis was applied to adjust for age, gender, body mass index (BMI), GFR, and the urinary protein/creatinine ratio. Proteinuria was in the nephrotic range in 44 and the BMI exceeded the 95th percentile in 57 patients of this cohort. Baseline lipid analysis found a high prevalence of hypertriglyceridemia in 126, increased non-HDL-C in 62, and reduced HDL-C in 83. Overall, 177 children had dyslipidemia, of whom 79 had combined dyslipidemia. Lower GFR was associated with higher triglycerides, lower HDL-C, and higher non-HDL-C. Nephrotic-range proteinuria was significantly associated with dyslipidemia and combined dyslipidemia. Compared with children with a GFR>50, children with a GFR<30 had significantly increased odds ratios for any dyslipidemia or for combined dyslipidemia. Hence, among children with moderate chronic kidney disease, dyslipidemia is common and is associated with lower GFR, nephrotic proteinuria, and non-renal factors including age and obesity.

Conflict of interest statement

Disclosure:

None of the authors’ have relationships with companies that may have a financial interest in the information contained in the manuscript.

Figures

Figure 1

Figures 1a, 1b, and 1c: Scatterplots of Triglycerides, HDL-C, and non-HDL-C, respectively, by GFR for N=391 children with moderate CKD overlayed with lowess smoothing curve (dashed line) and linear regression line (solid line). All axes are log scale.

Figure 2

Figures 2a and 2b: Prevalence of Dyslipidemia and combined dyslipidemia by (a) GFR and (b) Up/c for N=391 children with moderate CKD.