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Arterial Stiffness in Children and Young People With Hypertension and Chronic Kidney Disease

RecruitingN/A

Sponsor: King's College London

Conditions: Chronic Kidney Disease, Hypertension

Countries: United Kingdom

Age related stiffening and hardening of the arteries is often a slow process, but some conditions such as chronic kidney disease (CKD), seem to increase the rate at which the arteries stiffen even during childhood. High blood pressure (BP) is well known to lead to arterial stiffening and is often seen in children and young people (CYP) with CKD. A greater risk of arterial stiffening has been reported in children CYP with CKD compared to healthy CYP and this is thought to be related to the development of high BP, heart problems, and the worsening of kidney damage. The cause is unknown and is unlikely due to age related changes in the arterial wall seen in older adults. Potential mechanisms contributing to arterial stiffening in CYP with CKD include i) abnormalities in the interaction between the heart and the aorta (the large artery pumping blood away from the heart to the rest of the body), overactivity of the sympathetic nervous system (SNS), the body's "stress response", or iii) abnormal metabolism seen in CKD, where there are high levels of phosphate and other waste products circulating in the blood as a result of damage to the kidneys. In this study, the investigators will use a variety of non invasive experimental methods to determine if arterial stiffening seen in CYP with CKD is due solely to increased BP, or whether the other potential factors listed above also contribute. This may help to eventually identify how to prevent or treat arterial stiffness in CYP with CKD and prevent its adverse impact on kidney and heart health in later life. The investigators will compare findings between those with CKD and an age, sex and BP matched control group. This control group will comprise CYP both with high BP (primary hypertension) and without high BP (healthy participants).

Eligibility overview

Sex: ALL

Age: 10 Years to 25 Years

Healthy volunteers: Yes

Study type: OBSERVATIONAL

Eligibility criteria

Inclusion criteria:

For CKD participants:

* Aged 10-25 years at study entry.
* Diagnosis of CKD confirmed on at least two GFR assessments 3-months apart; eGFR will be estimated using routine bedside formulae (modified Schwartz). Participants may include those on dialysis or those with a functioning kidney transplant.
* Able to tolerate study investigations including 24-hour ABPM, echocardiogram, vascular assessments and MRI.

For controls:

* Aged 10-25 years at study entry
* Having completed study measurements as part of other research being completed by the research group and having consented to their anonymised data being used in future research within the same research theme.

Exclusion criteria (for all participants):

* Heart abnormalities or pre-existing cardiac disease including congenital heart disease, previous cardiac surgery or heart failure.
* Cardiac dysrhythmia.
* Inability to tolerate the required study investigations (out of office BP monitoring, applanation tonometry, cardiac MRI).

Locations (1)

London, Greater London, United Kingdom