TOPLINE:

Arterial stiffening and its progression were comparable between children with early chronic kidney disease (CKD) and healthy children; however, both higher blood pressure (BP) at baseline and increases in BP over time were strongly associated with faster progression of arterial stiffness, whereas kidney function was not.

METHODOLOGY:

• Researchers conducted a longitudinal observational sub-study within a randomised controlled trial to evaluate associations of arterial stiffening with BP and renal function in children with early CKD.
• The study included 151 children aged 3-10 years (46% girls) across multiple centres in the UK; of them, 106 children had CKD stages 1-3 and 45 were healthy. All participants completed at least two assessments of arterial stiffness and BP measured on the same day.
• Arterial stiffness was measured using carotid-femoral pulse wave velocity (PWV), and BP measurements were used to calculate the mean arterial pressure.
• Annual progressions of PWV and mean arterial pressure were calculated from changes between baseline and follow-up assessment, over a mean follow-up period of 3.1 years.

TAKEAWAY:

• During follow-up, the annual progression of PWV did not differ significantly between children with CKD and healthy children after adjusting for covariates.
• In healthy children, the annual progression of PWV was independently associated with the annual progression of mean arterial pressure (standardised regression coefficient [β], 0.49; P = .006).
• In children with CKD, the annual progression of PWV was significantly associated with both mean arterial pressure at baseline (β, 0.26; P = .007) and the annual progression of mean arterial pressure (β, 0.53; P < .001).
• The annual progression of PWV showed no significant association with kidney function in children with CKD.

IN PRACTICE:

"Interruption of the cycles of progression between BP, PWV and CKD at an early stage in life and in the disease process is therefore likely to be most impactful in the prevention of progression of arterial stiffening in children with CKD, and in turn its cardiovascular sequelae," the authors wrote. 

SOURCE:

This study was led by Louise Keehn, British Heart Foundation Centre, King's College London, London, England. It was published online on January 26, 2026, in Pediatric Nephrology.

LIMITATIONS:

Due to the small sample size, especially of the control group, the ability to detect modest associations was limited. The findings may not have been generalisable because none of the children had uncontrolled hypertension. The study could not adjust for the type or dose of antihypertensive therapies, which may have influenced arterial stiffness independently of BP.

DISCLOSURES:

The study was funded by the British Heart Foundation. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.