Study Finds Link Between Kidney Disease and Cardiovascular Risk in Children

In a study led by Michael Freundlich, M.D., professor of clinical pediatrics, and Wacharee Seeherunvong, M.D., assistant professor of clinical pediatrics, researchers in the Divisions of Pediatric Nephrology and Pediatric Cardiology found that elevated levels of the hormone fibroblast growth factor-23 (FGF-23) are strongly associated with heart disease in children and adolescents with advanced chronic kidney disease.

Initially published online in the journal Pediatric Nephrology, the study, “Fibroblast growth factor 23 and left ventricular hypertrophy in children on dialysis,” has important implications for children with chronic kidney disease. As their life expectancy continues to improve, the early identification of cardiovascular risk factors, like FGF-23, may become promising therapeutic targets.

Heart disease is the primary cause of death in people with chronic kidney disease, which affects 26 million Americans, including children and adolescents.

One of the most important markers of heart disease is left ventricular hypertrophy, the enlargement of the left-side pumping chamber of the heart. In patients with chronic kidney disease, blood levels of FGF-23 are markedly elevated, which is a strong predictor of future mortality in patients on dialysis and a likely cause of cardiac hypertrophy.

“Until now, these important findings have only been described in older adult patients exposed to the chemical derangements present in chronic kidney disease for longer periods of time,” said Freundlich, principal investigator on the study.

The study examined patients 21 years and younger, and elevated levels of the hormone were evident in children as young as 6.

Other Miller School co-authors included Carolyn L. Abitbol, M.D., professor of pediatrics; Jayanthi J. Chandar, M.D., associate professor of clinical pediatrics; Paolo G. Rusconi, M.D., associate professor of clinical pediatrics; and Gaston E. Zilleruelo, M.D., professor of pediatrics.

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