Risk factors for cardiovascular disease in children on maintenance dialysis

Cardiovascular disease mortality is high in children on maintenance dialysi s, accounting for about 25% of patient deaths. Cardiovascular-related morta lity rates for children on dialysis are higher than for children with succe ssful kidney transplants. Data on the long-term consequences of risk factor s for cardiovascular disease are lacking for pediatric end-stage renal dise ase patients. This article reviews pediatric data pertaining to the followi ng risk factors: anemia, hypertension, hyperlipidemia, left ventricular hyp ertrophy, abnormal calcium-phosphorus metabolism, and hyperhomocysteinemia. The potential relationship of end-stage renal disease to the etiology of s everal functional disorders of the cardiovascular system is discussed. Clin ical studies are needed to assess the prevalence of cardiovascular disease and of cardiovascular disease risk factors in the pediatric end-stage renal disease population. Possible preventive and therapeutic guidelines need to be developed for at-risk children on maintenance dialysis. (C) 2001 by the National Kidney Foundation, Inc.