Kidney Week

Abstract: FR-OR46

Acylcarnitines and Cardiovascular Outcomes in the CKD in Children (CKiD) and Chronic Renal Insufficiency Cohort (CRIC) Studies

Session Information

• Hypertension, CVD, and the Kidneys: Clinical Studies
  October 25, 2024 | Location: Room 5, Convention Center
  Abstract Time: 04:30 PM - 04:40 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Lee, Arthur, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States

Arthur Lee, MD

• Cai, Xuan, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Xuan Cai

• Mitsnefes, Mark, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

Mark Mitsnefes, MD, MS

• Furth, Susan L., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States

Susan L. Furth, MD, PhD

• Warady, Bradley A., Children's Mercy Kansas City, Kansas City, Missouri, United States

Bradley A. Warady, MD

• Isakova, Tamara, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Tamara Isakova, MD, MMSc

• Lash, James P., University of Illinois Chicago College of Medicine, Chicago, Illinois, United States

James P. Lash, MD, FASN

• Afshinnia, Farsad, University of Michigan Medical School, Ann Arbor, Michigan, United States

Farsad Afshinnia, MD, MS, FASN

• He, Jiang, Tulane University School of Medicine, New Orleans, Louisiana, United States

Jiang He, MD, PhD

• Jaar, Bernard G., Johns Hopkins Medicine, Baltimore, Maryland, United States

Bernard G. Jaar, MD, MPH, FASN

• Cohen, Jordana B., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States

Jordana B. Cohen, MD, MS, FASN

• Dobre, Mirela A., University Hospitals, Cleveland, Ohio, United States

Mirela A. Dobre, MD, FASN, MPH

• Rahman, Mahboob, University Hospitals, Cleveland, Ohio, United States

Mahboob Rahman, MD, MBBS

• Grams, Morgan, New York University Grossman School of Medicine, New York, New York, United States

Morgan Grams, MD, PhD

• Coresh, Josef, New York University Grossman School of Medicine, New York, New York, United States

Josef Coresh, MD, PhD, FASN

• Rhee, Eugene P., Massachusetts General Hospital, Boston, Massachusetts, United States

Eugene P. Rhee, MD

• Denburg, Michelle, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States

Michelle Denburg, MD

• Mehta, Rupal, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Rupal Mehta, MD, MS, FASN

Background

CKD is associated with poor cardiovascular (CV) outcomes in children and adults despite differences in etiology and cardiometabolic risk factors. We hypothesize that acylcarnitines (ACs), mitochondrial dysfunction biomarkers, are associated with poor CV outcomes in children and adults with CKD.

Methods

The CKiD and CRIC studies are multicenter prospective cohorts of children and adults with CKD respectively, with echocardiographic and metabolomic data. CKiD had follow-up echocardiograms and metabolomics. CRIC had follow-up echocardiograms. Multivariable regression models assessed the associations of ACs and left ventricular mass index (LVMI), elevated filling pressure (E/e’>8) (CKID), and heart failure (HF) events (CRIC).

Results

556 CKiD participants were included (median [interquartile range] age 11[8,15] years, eGFR 50[37,64] ml/min/1.73m², LVMI z-score 0.2[-0.7,1.0], 15% with E/e’>8) with 44 ACs assayed. 1747 CRIC participants were included (mean [standard deviation] age 59[11] years, eGFR 43[17] ml/min/1.73m², LVMI 64[24] g/m², 354 HF events over 10.1 years median follow-up) with 24 ACs assayed. Table 1 shows regression results of ACs and LVMI. Figure 1 shows regression results of ACs and elevated filling pressure and HF events.

Conclusion

ACs are associated with CV outcomes in both children and adults in CKD, despite their differences in CKD etiology and prevalence of diabetes and preexisting CV disease. This suggests a role for CKD-associated mitochondrial dysfunction in the development of CV disease.

Table 1

Figure 1

Funding

• NIDDK Support