The cardiovascular comorbidity in children with chronic kidney disease (4C) study

Objectives, design, and methodology

Uwe Querfeld, Ali Anarat, Aysun K. Bayazit, Aysin S. Bakkaloglu, Yelda Bilginer, Salim Caliskan, Mahmut Civilibal, Anke Doyon, Ali Duzova, Daniela Kracht, Mieczyslaw Litwin, Anette Melk, Sevgi Mir, Betül Sözeri, Rukshana Shroff, René Zeller, Elke Wühl, Franz Schaefer, L. B. Zimmerhackl, K. Arbeiter & 53 others J. Vande Walle, J. Dusek, P. Cochat, M. Fischbach, U. Querfeld, J. Dötsch, R. Büscher, M. Pohl, A. Melk, M. Kemper, F. Schaefer, E. Wühl, U. John, B. Hoppe, P. Sallay, M. Konrad, G. Klaus, M. Wigger, P. Sallay, G. Montini, A. Canepa, S. Testa, L. Murer, C. M. Matteucci, L. Peruzzi, A. Jankauskiene, D. Drozdz, M. Litwin, A. Niemirska, T. Urasinski, A. M. Zurowska, A. Caldas-Afonso, A. Peco-Antic, R. Krmar, G. Laube, G. Simonetti, A. Anarat, A. S. Bakkaloglu, F. Yalcinkaya, E. Baskin, N. Cakar, O. Soylemezoglu, G. Demircin, S. Caliskan, N. Canpolat, N. Yildiz, M. Civilibal, A. Kiyak, H. Alpay, G. Ozcelik, S. Emre, S. Mir, R. Shroff

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

Background and objectives: Children and adolescents with chronic kidney disease (CKD) are at high risk for cardiovascular morbidity and mortality. A systemic arteriopathy and cardiomyopathy has been characterized in pediatric dialysis patients by the presence of morphologic and functional abnormalities. Design, setting, participants, & measurements: The Cardiovascular Comorbidity in Children with CKD (4C) Study is a multicenter, prospective, observational study aiming to recruit more than 600 children, aged 6 to 17 years, with initial GFR of 10 to 45 ml/min per 1.73 m2. The prevalence, degree, and progression of cardiovascular comorbidity as well as its association with CKD progression will be explored through longitudinal follow-up. The morphology and function of the heart and large arteries will be monitored by sensitive noninvasive methods and compared with aged-matched healthy controls. Multiple clinical, anthropometric, biochemical, and pharmacologic risk factors will be monitored prospectively and related to the cardiovascular status. A whole-genome association study will be performed to identify common genetic variants associated with progression of cardiovascular alterations and/or renal failure. Monitoring will be continued as patients reach end-stage renal disease and undergo different renal replacement therapies. Results: While cardiovascular morbidity in adults is related to older age and additional risk factor load (e.g., diabetes), the role of CKD-specific factors in the initiation and progression of cardiac and vascular disease are likely to be characterized with greater sensitivity in the pediatric age group. Conclusions: The 4C study is expected to provide innovative insight into cardiovascular and renal disease progression in CKD.

Original languageEnglish
Pages (from-to)1642-1648
Number of pages7
JournalClinical Journal of the American Society of Nephrology
Volume5
Issue number9
DOIs
Publication statusPublished - Sep 1 2010

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Chronic Renal Insufficiency
Comorbidity
Disease Progression
Pediatrics
Morbidity
Peptide Initiation Factors
Renal Replacement Therapy
Genome-Wide Association Study
Cardiomyopathies
Vascular Diseases
Chronic Kidney Failure
Observational Studies
Renal Insufficiency
Dialysis
Heart Diseases
Cardiovascular Diseases
Arteries
Age Groups
Prospective Studies
Kidney

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

Cite this

The cardiovascular comorbidity in children with chronic kidney disease (4C) study : Objectives, design, and methodology. / Querfeld, Uwe; Anarat, Ali; Bayazit, Aysun K.; Bakkaloglu, Aysin S.; Bilginer, Yelda; Caliskan, Salim; Civilibal, Mahmut; Doyon, Anke; Duzova, Ali; Kracht, Daniela; Litwin, Mieczyslaw; Melk, Anette; Mir, Sevgi; Sözeri, Betül; Shroff, Rukshana; Zeller, René; Wühl, Elke; Schaefer, Franz; Zimmerhackl, L. B.; Arbeiter, K.; Vande Walle, J.; Dusek, J.; Cochat, P.; Fischbach, M.; Querfeld, U.; Dötsch, J.; Büscher, R.; Pohl, M.; Melk, A.; Kemper, M.; Schaefer, F.; Wühl, E.; John, U.; Hoppe, B.; Sallay, P.; Konrad, M.; Klaus, G.; Wigger, M.; Sallay, P.; Montini, G.; Canepa, A.; Testa, S.; Murer, L.; Matteucci, C. M.; Peruzzi, L.; Jankauskiene, A.; Drozdz, D.; Litwin, M.; Niemirska, A.; Urasinski, T.; Zurowska, A. M.; Caldas-Afonso, A.; Peco-Antic, A.; Krmar, R.; Laube, G.; Simonetti, G.; Anarat, A.; Bakkaloglu, A. S.; Yalcinkaya, F.; Baskin, E.; Cakar, N.; Soylemezoglu, O.; Demircin, G.; Caliskan, S.; Canpolat, N.; Yildiz, N.; Civilibal, M.; Kiyak, A.; Alpay, H.; Ozcelik, G.; Emre, S.; Mir, S.; Shroff, R.

In: Clinical Journal of the American Society of Nephrology, Vol. 5, No. 9, 01.09.2010, p. 1642-1648.

Research output: Contribution to journalArticle

Querfeld, U, Anarat, A, Bayazit, AK, Bakkaloglu, AS, Bilginer, Y, Caliskan, S, Civilibal, M, Doyon, A, Duzova, A, Kracht, D, Litwin, M, Melk, A, Mir, S, Sözeri, B, Shroff, R, Zeller, R, Wühl, E, Schaefer, F, Zimmerhackl, LB, Arbeiter, K, Vande Walle, J, Dusek, J, Cochat, P, Fischbach, M, Querfeld, U, Dötsch, J, Büscher, R, Pohl, M, Melk, A, Kemper, M, Schaefer, F, Wühl, E, John, U, Hoppe, B, Sallay, P, Konrad, M, Klaus, G, Wigger, M, Sallay, P, Montini, G, Canepa, A, Testa, S, Murer, L, Matteucci, CM, Peruzzi, L, Jankauskiene, A, Drozdz, D, Litwin, M, Niemirska, A, Urasinski, T, Zurowska, AM, Caldas-Afonso, A, Peco-Antic, A, Krmar, R, Laube, G, Simonetti, G, Anarat, A, Bakkaloglu, AS, Yalcinkaya, F, Baskin, E, Cakar, N, Soylemezoglu, O, Demircin, G, Caliskan, S, Canpolat, N, Yildiz, N, Civilibal, M, Kiyak, A, Alpay, H, Ozcelik, G, Emre, S, Mir, S & Shroff, R 2010, 'The cardiovascular comorbidity in children with chronic kidney disease (4C) study: Objectives, design, and methodology', Clinical Journal of the American Society of Nephrology, vol. 5, no. 9, pp. 1642-1648. https://doi.org/10.2215/CJN.08791209
Querfeld, Uwe ; Anarat, Ali ; Bayazit, Aysun K. ; Bakkaloglu, Aysin S. ; Bilginer, Yelda ; Caliskan, Salim ; Civilibal, Mahmut ; Doyon, Anke ; Duzova, Ali ; Kracht, Daniela ; Litwin, Mieczyslaw ; Melk, Anette ; Mir, Sevgi ; Sözeri, Betül ; Shroff, Rukshana ; Zeller, René ; Wühl, Elke ; Schaefer, Franz ; Zimmerhackl, L. B. ; Arbeiter, K. ; Vande Walle, J. ; Dusek, J. ; Cochat, P. ; Fischbach, M. ; Querfeld, U. ; Dötsch, J. ; Büscher, R. ; Pohl, M. ; Melk, A. ; Kemper, M. ; Schaefer, F. ; Wühl, E. ; John, U. ; Hoppe, B. ; Sallay, P. ; Konrad, M. ; Klaus, G. ; Wigger, M. ; Sallay, P. ; Montini, G. ; Canepa, A. ; Testa, S. ; Murer, L. ; Matteucci, C. M. ; Peruzzi, L. ; Jankauskiene, A. ; Drozdz, D. ; Litwin, M. ; Niemirska, A. ; Urasinski, T. ; Zurowska, A. M. ; Caldas-Afonso, A. ; Peco-Antic, A. ; Krmar, R. ; Laube, G. ; Simonetti, G. ; Anarat, A. ; Bakkaloglu, A. S. ; Yalcinkaya, F. ; Baskin, E. ; Cakar, N. ; Soylemezoglu, O. ; Demircin, G. ; Caliskan, S. ; Canpolat, N. ; Yildiz, N. ; Civilibal, M. ; Kiyak, A. ; Alpay, H. ; Ozcelik, G. ; Emre, S. ; Mir, S. ; Shroff, R. / The cardiovascular comorbidity in children with chronic kidney disease (4C) study : Objectives, design, and methodology. In: Clinical Journal of the American Society of Nephrology. 2010 ; Vol. 5, No. 9. pp. 1642-1648.
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abstract = "Background and objectives: Children and adolescents with chronic kidney disease (CKD) are at high risk for cardiovascular morbidity and mortality. A systemic arteriopathy and cardiomyopathy has been characterized in pediatric dialysis patients by the presence of morphologic and functional abnormalities. Design, setting, participants, & measurements: The Cardiovascular Comorbidity in Children with CKD (4C) Study is a multicenter, prospective, observational study aiming to recruit more than 600 children, aged 6 to 17 years, with initial GFR of 10 to 45 ml/min per 1.73 m2. The prevalence, degree, and progression of cardiovascular comorbidity as well as its association with CKD progression will be explored through longitudinal follow-up. The morphology and function of the heart and large arteries will be monitored by sensitive noninvasive methods and compared with aged-matched healthy controls. Multiple clinical, anthropometric, biochemical, and pharmacologic risk factors will be monitored prospectively and related to the cardiovascular status. A whole-genome association study will be performed to identify common genetic variants associated with progression of cardiovascular alterations and/or renal failure. Monitoring will be continued as patients reach end-stage renal disease and undergo different renal replacement therapies. Results: While cardiovascular morbidity in adults is related to older age and additional risk factor load (e.g., diabetes), the role of CKD-specific factors in the initiation and progression of cardiac and vascular disease are likely to be characterized with greater sensitivity in the pediatric age group. Conclusions: The 4C study is expected to provide innovative insight into cardiovascular and renal disease progression in CKD.",
author = "Uwe Querfeld and Ali Anarat and Bayazit, {Aysun K.} and Bakkaloglu, {Aysin S.} and Yelda Bilginer and Salim Caliskan and Mahmut Civilibal and Anke Doyon and Ali Duzova and Daniela Kracht and Mieczyslaw Litwin and Anette Melk and Sevgi Mir and Bet{\"u}l S{\"o}zeri and Rukshana Shroff and Ren{\'e} Zeller and Elke W{\"u}hl and Franz Schaefer and Zimmerhackl, {L. B.} and K. Arbeiter and {Vande Walle}, J. and J. Dusek and P. Cochat and M. Fischbach and U. Querfeld and J. D{\"o}tsch and R. B{\"u}scher and M. Pohl and A. Melk and M. Kemper and F. Schaefer and E. W{\"u}hl and U. John and B. Hoppe and P. Sallay and M. Konrad and G. Klaus and M. Wigger and P. Sallay and G. Montini and A. Canepa and S. Testa and L. Murer and Matteucci, {C. M.} and L. Peruzzi and A. Jankauskiene and D. Drozdz and M. Litwin and A. Niemirska and T. Urasinski and Zurowska, {A. M.} and A. Caldas-Afonso and A. Peco-Antic and R. Krmar and G. Laube and G. Simonetti and A. Anarat and Bakkaloglu, {A. S.} and F. Yalcinkaya and E. Baskin and N. Cakar and O. Soylemezoglu and G. Demircin and S. Caliskan and N. Canpolat and N. Yildiz and M. Civilibal and A. Kiyak and H. Alpay and G. Ozcelik and S. Emre and S. Mir and R. Shroff",
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TY - JOUR

T1 - The cardiovascular comorbidity in children with chronic kidney disease (4C) study

T2 - Objectives, design, and methodology

AU - Querfeld, Uwe

AU - Anarat, Ali

AU - Bayazit, Aysun K.

AU - Bakkaloglu, Aysin S.

AU - Bilginer, Yelda

AU - Caliskan, Salim

AU - Civilibal, Mahmut

AU - Doyon, Anke

AU - Duzova, Ali

AU - Kracht, Daniela

AU - Litwin, Mieczyslaw

AU - Melk, Anette

AU - Mir, Sevgi

AU - Sözeri, Betül

AU - Shroff, Rukshana

AU - Zeller, René

AU - Wühl, Elke

AU - Schaefer, Franz

AU - Zimmerhackl, L. B.

AU - Arbeiter, K.

AU - Vande Walle, J.

AU - Dusek, J.

AU - Cochat, P.

AU - Fischbach, M.

AU - Querfeld, U.

AU - Dötsch, J.

AU - Büscher, R.

AU - Pohl, M.

AU - Melk, A.

AU - Kemper, M.

AU - Schaefer, F.

AU - Wühl, E.

AU - John, U.

AU - Hoppe, B.

AU - Sallay, P.

AU - Konrad, M.

AU - Klaus, G.

AU - Wigger, M.

AU - Sallay, P.

AU - Montini, G.

AU - Canepa, A.

AU - Testa, S.

AU - Murer, L.

AU - Matteucci, C. M.

AU - Peruzzi, L.

AU - Jankauskiene, A.

AU - Drozdz, D.

AU - Litwin, M.

AU - Niemirska, A.

AU - Urasinski, T.

AU - Zurowska, A. M.

AU - Caldas-Afonso, A.

AU - Peco-Antic, A.

AU - Krmar, R.

AU - Laube, G.

AU - Simonetti, G.

AU - Anarat, A.

AU - Bakkaloglu, A. S.

AU - Yalcinkaya, F.

AU - Baskin, E.

AU - Cakar, N.

AU - Soylemezoglu, O.

AU - Demircin, G.

AU - Caliskan, S.

AU - Canpolat, N.

AU - Yildiz, N.

AU - Civilibal, M.

AU - Kiyak, A.

AU - Alpay, H.

AU - Ozcelik, G.

AU - Emre, S.

AU - Mir, S.

AU - Shroff, R.

PY - 2010/9/1

Y1 - 2010/9/1

N2 - Background and objectives: Children and adolescents with chronic kidney disease (CKD) are at high risk for cardiovascular morbidity and mortality. A systemic arteriopathy and cardiomyopathy has been characterized in pediatric dialysis patients by the presence of morphologic and functional abnormalities. Design, setting, participants, & measurements: The Cardiovascular Comorbidity in Children with CKD (4C) Study is a multicenter, prospective, observational study aiming to recruit more than 600 children, aged 6 to 17 years, with initial GFR of 10 to 45 ml/min per 1.73 m2. The prevalence, degree, and progression of cardiovascular comorbidity as well as its association with CKD progression will be explored through longitudinal follow-up. The morphology and function of the heart and large arteries will be monitored by sensitive noninvasive methods and compared with aged-matched healthy controls. Multiple clinical, anthropometric, biochemical, and pharmacologic risk factors will be monitored prospectively and related to the cardiovascular status. A whole-genome association study will be performed to identify common genetic variants associated with progression of cardiovascular alterations and/or renal failure. Monitoring will be continued as patients reach end-stage renal disease and undergo different renal replacement therapies. Results: While cardiovascular morbidity in adults is related to older age and additional risk factor load (e.g., diabetes), the role of CKD-specific factors in the initiation and progression of cardiac and vascular disease are likely to be characterized with greater sensitivity in the pediatric age group. Conclusions: The 4C study is expected to provide innovative insight into cardiovascular and renal disease progression in CKD.

AB - Background and objectives: Children and adolescents with chronic kidney disease (CKD) are at high risk for cardiovascular morbidity and mortality. A systemic arteriopathy and cardiomyopathy has been characterized in pediatric dialysis patients by the presence of morphologic and functional abnormalities. Design, setting, participants, & measurements: The Cardiovascular Comorbidity in Children with CKD (4C) Study is a multicenter, prospective, observational study aiming to recruit more than 600 children, aged 6 to 17 years, with initial GFR of 10 to 45 ml/min per 1.73 m2. The prevalence, degree, and progression of cardiovascular comorbidity as well as its association with CKD progression will be explored through longitudinal follow-up. The morphology and function of the heart and large arteries will be monitored by sensitive noninvasive methods and compared with aged-matched healthy controls. Multiple clinical, anthropometric, biochemical, and pharmacologic risk factors will be monitored prospectively and related to the cardiovascular status. A whole-genome association study will be performed to identify common genetic variants associated with progression of cardiovascular alterations and/or renal failure. Monitoring will be continued as patients reach end-stage renal disease and undergo different renal replacement therapies. Results: While cardiovascular morbidity in adults is related to older age and additional risk factor load (e.g., diabetes), the role of CKD-specific factors in the initiation and progression of cardiac and vascular disease are likely to be characterized with greater sensitivity in the pediatric age group. Conclusions: The 4C study is expected to provide innovative insight into cardiovascular and renal disease progression in CKD.

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