Table 4.
Calcification in children with CKD
| Study | Type | Population | Findings | CAC Associations | Notes |
|---|---|---|---|---|---|
| Milliner et al. 1990 (99) | Retrospective autopsy series | 120 pediatric CKD, dialysis, RT | 10% w/CAC; soft tissue calcification in 60% | Vitamin D, age at onset of ESRD, Ca x P, male sex | Autopsy study; 4 patients w/evidence of MI or calcification of myocardium |
| Goodman et al. 2000 (100) | Cross- sectional | 39 dialysis pts (age 7–30); 60 controls | No CAC in pts <20 yrs; 14/16 pts>20 years w/CAC | Age, serum P, duration of dialysis, Ca intake, Ca x P | 10 patients w/CAC had f/u scan at mean 20 mos; calcification score nearly doubled |
| Oh et al. 2002 (86) | Cross- sectional | 19–39 yr old childhood CKD survivors (n=37) | 92% w/CAC | Current dialysis, dialysis duration, iPTH, CRP, Ca x P, C pneumoniae seropositivity, homocysteine | 34% also w/cardiac valve calcification; 32% w/aortic calcification |
| Ishitani et al. 2005 (101) | Cross- sectional | 21–48 yr old pediatric RT recipients (n=19) | 47% w/CAC, all in pts >30 yrs old | None identified as significant | 12 pts never dialyzed; 6 w/≤6 months total dialysis time; 1 w/24 months total dialysis |
| Briese et al. 2006 (90) | Cross- sectional | 40 young adults w/childhood ESRD | 10% w/moderate to severe CAC. | Age, ESRD duration; time on dialysis; BP; cIMT; total Ca dose, Vit. D intake | Relatively low Ca intake & Vit D compared to other study populations |
| Civilibal et al. 2006 (102) | Cross- sectional | Children w/ESRD (15 HD, 24 PD, 14 RT) | 15% w/CAC (20% HD, 12.5% PD, 14% RT) | Dialysis duration, serum P, Ca x P, iPTH, & vitB12; Hgb; total Ca & Vit D doses | 3 patients w/severe (high probability of stenosis) lesions. |
| Shroff et al. 2007 (92) | Cross-sectional | 85 children on dialysis>6 mos | 20% w/CAC (27% among those w/iPTH ≥ 2x upper limit of normal) | Time integrated iPTH, serum phosphorous | 2 w/severe CAC; only high iPTH group had moderate/severe CAC |
| Civilibal et al. 2009 (103) | Prospective cohort | 48 children w/ESRD; 8 w/baseline CAC | 0% CAC incidence. Among those with baseline CAC, median score increased |
Final Ca x P; inverse association w/serum albumin | 1 CAC resolution; 3 w/mild decrease; 3 w/moderate increase; 1 w/large increase |
BP, blood pressure; Ca X P, calcium-phosphorous product; CAC, coronary artery calcification; cIMT, carotid intima media thickness; CKD, chronic kidney disease; CRP, c-reactive protein; ESRD, end-stage renal disease; HD, hemodialysis; Hgb, hemoglobin; PD, peritoneal dialysis; Hgb, hemoglobin; RT, renal transplant.