[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-detail-203540-en":59,"doc-seo-203540-105":81},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":5,"data":60},{"doc_id":61,"user_id":62,"nickname":63,"user_avatar":64,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":66,"doc_content":67,"file_id":68,"file_url":69,"file_type":70,"file_size":71,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":72,"language":73,"language_code":74,"site_id":75,"html_lang":74,"table_of_contents":76,"faqs":77,"seo_title":78,"seo_description":66,"update_tm":79,"read_time":80},203540,19241457091524,"Gelato","https://us-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","Uraemic vascular damage and calcification in children on dialysis - Prevention vs damage limitation?","This document discusses cardiovascular disease (CVD) in children with chronic kidney disease (CKD), its epidemiology, and the onset of vascular damage. It explores the nature of vascular damage, risk factors, and findings from clinical studies. The role of calcium and phosphate in vascular injury is highlighted, along with evidence of vascular damage and calcification through clinico-pathological correlations. The document also presents mortality data in childhood-onset CKD, indicating that CVD is the leading cause of death, with a graded association between Glomerular Filtration Rate (GFR) and CVD. Metabolic disturbances in early CKD, such as elevated FGF-23, reduced Vitamin D, elevated PTH, and high Ca x P products, are presented as contributing factors. Risk factors for vascular injury in CKD are detailed, including traditional risk factors and those specific to CKD patients, such as abnormal calcium and phosphate levels, hyperparathyroidism, inflammation, oxidative stress, and perturbations in physiological inhibitors. Key clinical studies in children with calcification reveal associations with older age, longer dialysis vintage, higher P and Ca x P levels, and increased calcium intake from binders.","Uraemic vascular damage andcalcificationin children on dialysis  \n# Prevention vs damage limitation?\n\nRukshana Shroff  \nGreat Ormond Street Hospital andInstitute of Child Health,London,United Kingdom  \n# Cardiovascular disease in children-\n\ndoes it happen?  \nOutline  \n·CVD in childhood CKD  \n-epidemiology  \n-when does it begin?  \n·What is the nature of the vascular damage?-Risk factors-Clinical studies  \n·Is there direct evidence of vascular damage andcalcification?  \n-Clinico-pathological correlationsThe role of Ca and P in vascular injury  \n# Mortality in childhood-onset CKD\n\n% paients alive  \nOh et al,Circulation,2002  \nCVD is the most common cause ofdeath in childhood CKD  \nUS  \n-38%deaths were from CVDChavers et al,KI 2002Dutch cohort study  \n-24%deaths due to CVD/cerebrovascular diseaseGroothoff et al,KI 2002-57%deaths on HD and 43%on PD are due tocardiac causesMcDonald et al,NEJM 2004  \nANZDATA  \nThere is an independent and gradedassociation between GFR and CVD  \nEstimated GFR(ml/min/173 m²)o.of Events 73,10834,69018,580  8809  3824  \n# Metabolic disturbances in early CKD\n\nGFR 90  \n↑FGF-23↓Vitamin D个PTH↑CaxPLevin et al,Kl;2007Dialysis  \n# Arteriosclerosis\n\nAtherosclerosis  \n# Risk factors for vascular injury\n\nRisk factors in CKD  \n'Traditional'riskfactors  \n·Abnormal Ca&Phosphate  \n·Hypertension·Hyperpapathyroidism  \n·Diabetes·?Vitamin D analogues  \n·ChronIC TIUIa overload  \n·Hypercholesterolemia  \n·Dyslipidemia·Inflammation  \n·Insulin resistance·Oxidative stress  \n·Obesity·Hyperhomocysteinemia  \n·Smoking·Albuminuria  \n·Male gender·Malnutrition  \n·Family history of CVD·Perturbation in physiologicalinhibitors (fetuin-A,OPG)  \n·Abnormal FGF-23 levels  \n# Clinical studies in children一\n\nkey papers  \nPatients with  \ncalcification were:-older  \n-longer dialysis vintage-Higher P&CaxP-Higher Ca intake frombindersGoodman et al,NEJM,2000","cbCairTCEMDhciSK","https://ap.wps.com/l/cbCairTCEMDhciSK","pdf",3707357,41,"English","en",105,"# Uraemic vascular damage and calcification in children on dialysis\n# Prevention vs damage limitation?\n## Cardiovascular disease in children - does it happen?\n### Outline\n### Mortality in childhood-onset CKD\n### Metabolic disturbances in early CKD\n### Arteriosclerosis\n### Risk factors for vascular injury\n### Clinical studies in children – key papers","[{\"question\":\"What is the main cause of death in children with chronic kidney disease?\",\"answer\":\"Cardiovascular disease (CVD) is the most common cause of death in children with chronic kidney disease (CKD).\"},{\"question\":\"What are the key metabolic disturbances observed in early stages of chronic kidney disease?\",\"answer\":\"In early CKD (GFR \\u003e 90), there is an increase in FGF-23, a decrease in Vitamin D, and an elevation in PTH, leading to potentially abnormal calcium and phosphate levels. Dialysis initiation brings further metabolic challenges.\"},{\"question\":\"What factors are associated with vascular calcification in children on dialysis?\",\"answer\":\"Patients with calcification were observed to be older, have longer dialysis vintage, higher phosphate (P) and calcium-phosphate (Ca x P) levels, and higher calcium intake from binders.\"}]","Uraemic vascular damage and calcification in children on dialysis - Prevention vs damage limitation? | PDF",1788561711,103,{"code":4,"msg":82,"data":83},"ok",{"site_id":75,"language":74,"slug":84,"title":65,"keywords":85,"description":66,"schema_data":86,"social_meta":140,"head_meta":142,"extra_data":144,"updated_unix":79},"uraemic-vascular-damage-and-calcification-in-children-on-dialysis-prevention-vs-damage-limitation","",{"@graph":87,"@context":139},[88,102,122],{"@type":89,"itemListElement":90},"BreadcrumbList",[91,95,97,100],{"item":92,"name":93,"@type":94,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":96,"name":9,"@type":94,"position":14},"https://docshare.wps.com/document/",{"item":98,"name":35,"@type":94,"position":99},"https://docshare.wps.com/document/healthcare/",3,{"item":101,"name":65,"@type":94,"position":19},"https://docshare.wps.com/document/uraemic-vascular-damage-and-calcification-in-children-on-dialysis-prevention-vs-damage-limitation/203540/",{"url":101,"name":65,"@type":103,"image":104,"author":109,"headline":65,"publisher":111,"fileFormat":114,"inLanguage":74,"description":66,"dateModified":115,"datePublished":116,"encodingFormat":114,"isAccessibleForFree":117,"interactionStatistic":118},"DigitalDocument",{"url":105,"@type":106,"width":107,"height":108},"https://docshare.wps.com/thumbnails/uraemic-vascular-damage-and-calcification-in-children-on-dialysis-prevention-vs-damage-limitation/203540.png","ImageObject",300,407,{"name":63,"@type":110},"Person",{"url":92,"name":112,"@type":113},"DocShare","Organization","application/pdf","2026-10-06","2026-09-04",true,{"@type":119,"interactionType":120,"userInteractionCount":44},"InteractionCounter",{"@type":121},"ViewAction",{"@type":123,"mainEntity":124},"FAQPage",[125,131,135],{"name":126,"@type":127,"acceptedAnswer":128},"What is the main cause of death in children with chronic kidney disease?","Question",{"text":129,"@type":130},"Cardiovascular disease (CVD) is the most common cause of death in children with chronic kidney disease (CKD).","Answer",{"name":132,"@type":127,"acceptedAnswer":133},"What are the key metabolic disturbances observed in early stages of chronic kidney disease?",{"text":134,"@type":130},"In early CKD (GFR > 90), there is an increase in FGF-23, a decrease in Vitamin D, and an elevation in PTH, leading to potentially abnormal calcium and phosphate levels. Dialysis initiation brings further metabolic challenges.",{"name":136,"@type":127,"acceptedAnswer":137},"What factors are associated with vascular calcification in children on dialysis?",{"text":138,"@type":130},"Patients with calcification were observed to be older, have longer dialysis vintage, higher phosphate (P) and calcium-phosphate (Ca x P) levels, and higher calcium intake from binders.","https://schema.org",{"og:url":101,"og:type":141,"og:title":65,"og:site_name":112,"og:description":66},"article",{"robots":143,"canonical":101},"index,follow",{"doc_id":61,"site_id":75}]