The Cardiovascular Comorbidity in Children With Chronic Kidney Disease Study
- Conditions
- PediatricCardiovascular DiseaseChronic Kidney Disease
- Registration Number
- NCT01046448
- Lead Sponsor
- Heidelberg University
- Brief Summary
Children and adolescents with chronic kidney disease (CKD) are at high risk for cardiovascular (CV) morbidity and mortality. Recent studies suggest that pediatric patients with even moderately impaired kidney function may be afflicted with significant early cardiac and vascular abnormalities.
The pathogenesis and the natural course of CV comorbidity in pediatric CKD patients is still elusive. In this multicenter, prospective, observational study the prevalence, degree and progression of CV comorbidity in children will be characterized and related to CKD progression. The morphology and function of the heart and vessels will be monitored by sensitive, non-invasive methods and will be compared with aged matched healthy controls. Multiple potential clinical, anthropometric, biochemical, and pharmacological risk factors will be monitored prospectively and will be related to CV status. Genotyping might identify predisposing genetic factors for progression of CV comorbidity and underlying nephropathies.
- Detailed Description
Adult patients with CKD are at markedly increased risk of dying from cardiovascular events. The risk is most dramatically increased in young patients with end-stage renal disease, who are almost as likely to die from cardiovascular causes as elderly individuals in the general population.
Early morphological and functional vascular abnormalities can be detected even in adolescents with CKD, but information about the prevalence, severity and natural course of vascular lesions in different stages of renal failure is lacking and the factors predisposing to an early onset and rapid progression of cardiovascular morbidity are still elusive.
The pediatric population appears uniquely suited to study the effects of CKD on the cardiovascular system due to the virtual absence of vascular morbidity related to ageing, diabetes and smoking.
In order to improve our understanding of the causes and consequences of cardiovascular comorbidity in children with progressive CKD, a consortium of pediatric nephrologists in Europe has joined to perform a long-term prospective observational study following the cardiovascular health of children as they advance through successive stages of CKD.
The 4C Study will follow up at least 625 patients aged 6 to 17 years with a glomerular filtration rate of 10 to 45 ml/min/1.73 m² in more than 40 pediatric nephrology units in 14 European countries.
The morphology and function of the heart and the large arteries is regularly assessed by sensitive, non-invasive methods and the findings compared to a large group of healthy children.
Multiple potential clinical, anthropometric, biochemical, and pharmacological risk factors are monitored prospectively and will be related to the cardiovascular status of the patients.
A whole genome association study will be performed to identify genetic variants associated with the progression of cardio-vascular alterations and renal failure.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 650
- Age 6 to 17 years
- GFR 10 to 45 ml/min/1.73m² (CKD stage IIIb to V);
- Active systemic vasculitis
- Diabetes mellitus
- Renal vascular anomalies
- Anomalies of the limbs preventing standardized diagnostic procedures
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Functional and morphological evidence of cardiovascular disease progression (arterial stiffness, myocardial dysfunction, cIMT, LVMI) and association with clinical, anamnestic, anthropometric, biochemical, drug-related and genetic risk factors 3 years
- Secondary Outcome Measures
Name Time Method Genetic risk factors for early manifesting progressive vascular lesions and progressive kidney disease by the genome-wide SNP-screening and haplotype analysis. 3 years
Trial Locations
- Locations (43)
Medical University of Vienna
🇦🇹Vienna, Austria
Vilnius University Children's Hospital
🇱🇹Vilnius, Lithuania
Hôpital de Hautepierre
🇫🇷Strasbourg, France
University Children's Hospital
🇨🇭Zurich, Switzerland
Center for Pediatrics and Adolescent Medicine
🇩🇪Heidelberg, Germany
City Hospital St. Georg
🇩🇪Leipzig, Germany
Children's Hospital
🇩🇪Rostock, Germany
University of Padova
🇮🇹Padova, Italy
Regina Margherita Children's Hospital
🇮🇹Torino, Italy
UKE University Children's Hospital
🇩🇪Hamburg, Germany
UZ Gent
🇧🇪Gent, Belgium
Semmelweis University
🇭🇺Budapest, Hungary
Hannover Medical School
🇩🇪Hannover, Germany
S. Orsola-Malphighi Hospital
🇮🇹Bologna, Italy
University Hospital Motol
🇨🇿Prague, Czech Republic
Service de Pédiatrie & Inserm U820
🇫🇷Lyon, France
Charité Children's Hospital
🇩🇪Berlin, Germany
KfH Kidney Center for Children
🇩🇪Marburg, Germany
Fondazione OSP Maggiore Policlinico
🇮🇹Milano, Italy
Bambino Gesu
🇮🇹Rome, Italy
Gazi University Hospital
🇹🇷Ankara, Turkey
Cerrahpasa Tip Fakultesi
🇹🇷Istanbul, Turkey
Bakirkoy Children's Hospital
🇹🇷Istanbul, Turkey
Children's Memorial Health Institute
🇵🇱Warsaw, Poland
Hospital Sao Joao
🇵🇹Porto, Portugal
Inselspital
🇨🇭Bern, Switzerland
Diskapi Childrens Hospital
🇹🇷Ankara, Turkey
Marmara University Medical Faculty
🇹🇷Istanbul, Turkey
Ege University
🇹🇷Izmir, Turkey
Istituto Giannina Gaslini
🇮🇹Genova, Italy
Haseki Educational and Research Hospital
🇹🇷Istanbul, Turkey
Medical University Gdansk
🇵🇱Gdansk, Poland
Cukurova Universitesi
🇹🇷Adana, Turkey
Hacettepe Medical Faculty
🇹🇷Ankara, Turkey
Clinic of Pediatrics
🇵🇱Szczecin, Poland
Karolinska University Hospital
🇸🇪Stockholm, Sweden
Ankara University of Medicine
🇹🇷Ankara, Turkey
Baskent University, Faculty of Medicine
🇹🇷Ankara, Turkey
Sami Ulus Childrens Hospital
🇹🇷Ankara, Turkey
Goztepe Educational and Research Hospital
🇹🇷Istanbul, Turkey
Sisli Educational and Research Hospital
🇹🇷Istanbul, Turkey
Istanbul Medical Faculty
🇹🇷Istanbul, Turkey
Great Ormond Street Hospital
🇬🇧London, United Kingdom