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소아 만성 콩팥병에서 나타나는 심혈관계 질환

Cardiovascular Disease in Pediatric Chronic Kidney Disease

조민현
대한소아신장학회 (The Korean Society Of Pediatric Nephrology)|2014.04|Childhood Kidney Diseases (Childhood Kidney diseases)|제18권 제1호|pp. 7-12

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참고문헌

키워드

ChildrenCardiovascular diseaseChronic kidney disease
주제분류소아과학

초록

만성 콩팥병의 장기 예후를 결정하는 요인 중 심혈관계합병증의 중요성은 잘 알려져 있다. 그러나 소아 환자의 경우 전형적인 증상 발현이 적어 그 임상적 중요성이 간과되는 경향이 있다. 현재까지 알려진 심혈관계 합병증의 위험인자로는 고혈압, 당뇨병, 이상지질혈증, 비만과 같은 전통적인 위험 인자와 빈혈, 이차성 부갑상선 기능항진증, 산화 스트레스, 염증과 같은 새로운 위험 인자 등이 알려져 있다. 소아 만성 콩팥병의 경우 주로 좌심실 비대나 경동맥 내중막 두께의 증가 및 관상동맥의 석회화 같이 대부분 겉으로드러나지 않는 증상이므로 위험 인자에 대한 철저한 관리와 지속적인 추적 관찰이 필수적이다.

Abstract

Cardiovascular disease (CVD) has been identified as one of the most important factors influencing the long-term prognosis of patients with chronic kidney disease (CKD). However, in pediatric CKD, the clinical importance of CVD tends to be overlooked due to the lack of typical manifestations of CVD in this population. The literature has identified several traditional risk factors of CVD that originate from CKD, including hypertension, diabetes mellitus, dyslipidemia and obesity, in addition to new and non-traditional risk factors including anemia, secondary hyperparathyroidism, oxidative stress and inflammation. In cases of pediatric CKD, cardiovascular disease is usually restricted to subclinical manifestations such as left ventricular hypertrophy, thickening of intimal media on the carotid artery and calcification of the coronary artery. Therefore, risk factors of CVD in pediatric CKD patients should be closely monitored.

참고문헌 (34)

  1. Foley RN, "Clinical epidemiology of cardiovascular disease in chronic renal disease", Am J Kidney Dis, 32(5 Suppl 3), pp.S112~S119 (1998)
  2. Chavers BM, "Cardiovascular disease in pediatric chronic dialysis patients", Kidney Int, 62, pp.648~653 (2002)
  3. Weiner DE, "Chronic kidney disease as a risk factor for cardiovascular disease and all-cause mortality : a pooled analysis of community-based studies", J Am Soc Nephrol, 15, pp.1307~1315 (2004)
  4. Parekh RS, "Cardiovascular mortality in children and young adults with end-stage kidney disease", J Pediatr, 141, pp.191~197 (2002)
  5. Groothoff JW, "Mortality and causes of death of endstage renal disease in children : a Dutch cohort study", Kidney Int, 61, pp.621~629 (2002)
  6. USRDS 2000 Annual Data Report, 2000, "U. S. Renal Data System", The National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, ~ (2000)
  7. USRDS 2008 Annual Data Report, 2008, "U. S. Renal Data System", The National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, ~ (2008)
  8. Mitsnefes M, "Hypertension and progression of chronic renal insufficiency in children: a report of the North American Pediatric Renal Transplant Cooperative Study (NAP RTCS)", J Am Soc Nephrol, 14, pp.2618~2622 (2003)
  9. Mitsnefes M, "Hypertension in pediatric patients on long-term dialysis : a report of the North American Pediatric Renal Transplant Cooperative Study(NAPRTCS)", Am J Kidney Dis, 45, pp.309~315 (2005)
  10. Flynn JT, "Blood pressure in children with chronic kidney disease : a report from the Chronic Kidney Disease in Children study", Hypertension, 52, pp.631~637 (2008)
  11. Hanevold CD, "Obesity and renal transplant outcome : a report of the North American Pediatric Renal Transplant Cooperative Study", Pediatrics, 115, pp.352~356 (2005)
  12. Mitsnefes MM, "Body mass index and allograft function in pediatric renal transplantation", Pediatr Nephrol, 17, pp.535~539 (2002)
  13. Prokai A, "Post-transplant diabetes mellitus in children following renal transplantation", Pediatr Transplant, 12, pp.643~649 (2008)
  14. Lai HL, "Hyperinsulinemia in pediatric patients with chronic kidney disease : the role of tumor necrosis factor-alpha", Pediatr Nephrol, 22, pp.1751~1756 (2007)
  15. Painter P, "Exercise capacity and physical fitness in pediatric dialysis and kidney transplant patients", Pediatr Nephrol, 22, pp.1030~1039 (2007)
  16. Weaver DJ, Jr, "Decreased maximal aerobic capacity in pediatric chronic kidney disease", J Am Soc Nephrol, 19, pp.624~630 (2008)
  17. Himmelfarb J, "The elephant in uremia : oxidant stress as a unifying concept of cardiovascular disease in uremia", Kidney Int, 62, pp.1524~1538 (2002)
  18. Wilson AC, "Cardiovascular disease in CKD in children : update on risk factors, risk assessment, and management", Am J Kidney Dis, 54, pp.345~360 (2009)
  19. Vanholder R, "Chronic kidney disease as cause of cardiovascular morbidity and mortality", Nephrol Dial Transplant, 20, pp.1048~1056 (2005)
  20. VanDeVoorde RG, "Blood pressure control in pediatric hemodialysis:the Midwest Pediatric Nephrology Consortium Study", Pediatr Nephrol, 22, pp.547~553 (2007)
  21. Ulinski T, "Reduction of left ventricular hypertrophy in children undergoing hemodialysis", Pediatr Nephrol, 21, pp.1171~1178 (2006)
  22. Fadrowski JJ, "Hemoglobin decline in children with chronic kidney disease: baseline results from the chronic kidney disease in children prospective cohort study", Clin J Am Soc Nephrol, 3, pp.457~462 (2008)
  23. Jono S, "1,25-Dihydroxyvitamin D3 increases in vitro vascular calcification by modulating secretion of endogenous parathyroid hormone-related peptide", Circulation, 98, pp.1302~1306 (1998)
  24. Mitsnefes MM, "Cardiovascular morbidity and mortality in children with chronic kidney disease in North America: lessons from the USRDS and NAPRTCS databases", Perit Dial Int, 25(Suppl 3), pp.S120~S122 (2005)
  25. Gruppen MP, "Cardiac disease in young adult patients with end-stage renal disease since childhood: a Dutch cohort study", Kidney Int, 63, pp.1058~1065 (2003)
  26. Matteucci MC, "Left ventricular geometry in children with mild to moderate chronic renal insufficiency", J Am Soc Nephrol, 17, pp.218~226 (2006)
  27. Kavey RE, "Cardiovascular risk reduction in high-risk pediatric patients: a scientific statement from the American Heart Association Expert Panel on Population and Prevention Science; the Councils on Cardiovascular Disease in the Young, Epidemiology and Prevention, Nutrition, Physical Activity and Metabolism, High Blood Pressure Research, Cardiovascular Nursing, and the Kidney in Heart Disease; and the Interdisciplinary Working Group on Quality of Care and Outcomes Research: endorsed by the American Academy of Pediatrics", Circulation, 114, pp.2710~2738 (2006)
  28. "The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents", Pediatrics, 114, pp.555~576 (2004), Pediatrics
  29. Kasiske B, "Managing dyslipidemias in chronic kidney disease", Nephrol News Issues, 17, pp.81~83 (2003)
  30. Daniels SR, "Lipid screening and cardiovascular health in childhood", Pediatrics, 122(1), pp.198~208 (2008)
  31. de Ferranti S, "Storm over statins--the contro-versy surrounding pharmacologic treatment of children", N Engl J Med, 359, pp.1309~1312 (2008)
  32. Nelson RG, "The new KDOQI clinical practice guidelines and clinical practice recommendations for diabetes and CKD", Blood Purif, 25, pp.112~114 (2007)
  33. "KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Anemia in Chronic Kidney Disease", Am J Kidney Dis, 47(5 Suppl 3), pp.S11~S145 (2006)
  34. Delucchi A, "Carotid intima-media thickness as a cardiovascular risk marker in pediatric end-stage renal disease patients on dialysis and in renal transplantation", Transplant Proc, 40, pp.3244~3246 (2008)

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