Currently Viewing:
Kidney Week 2019
Time to Focus on Increasing Organs for Patients With ESRD, Azar Says at Kidney Week
November 07, 2019
Currently Reading
Dr Tammy Brady Discusses the Role of the Pediatric Nephrologist on the Care Team for Metabolic Syndrome
November 07, 2019
Dr Cynthia Delgado on the Importance of Patient Input in Kidney Disease Care
November 08, 2019
Data From 3 Roxadustat Trials Lead Off Kidney Week Sessions Ahead of Efficacy, Safety News
November 08, 2019
Dr Joseph Vassalotti Presents Findings of AJMC® Study on CKD Intervention
November 08, 2019
Dr Alan Kliger Outlines Major Safety Risks for Patients Receiving Dialysis
November 08, 2019
Researchers Develop Tool to Identify Those at Risk of Future CKD
November 08, 2019
Paul Conway: Respect, Listening Are Keys to Engaging Patients in Kidney Care
November 08, 2019
Pooled Cardiovascular Data on Roxadustat Show No Increased Risk to Patients With CKD
November 08, 2019
Dr Jay Wish Explains Implications of New Roxadustat Data
November 09, 2019
Patients on Dialysis Have More Hospitalizations in Areas With More Black Residents
November 09, 2019
Physicians, Patient Discuss Intentional Nonadherence in Hypertension Therapy
November 10, 2019
Dr Holly Kramer Discusses Components of the Advancing American Kidney Health Initiative
November 11, 2019
Early Warning Signs of CKD Going Unnoticed in Veterans, Especially Those With Hypertension
November 11, 2019
As Kidney Week Ends, Providers Are Urged to Join New Care Models
November 11, 2019
Understanding More About Quality of Life Impact for Patients With CKD, Anemia
November 11, 2019

Dr Tammy Brady Discusses the Role of the Pediatric Nephrologist on the Care Team for Metabolic Syndrome

Pediatric nephrologists are a key piece of the care team for children with metabolic syndrome because they have continual opportunities to identify and treat risk factors for cardiovascular disease, according to Tammy Brady, MD, PhD, medical director of the Pediatric Hypertension Program and associate professor of pediatrics at Johns Hopkins University.


Pediatric nephrologists are a key piece of the care team for children with metabolic syndrome because they have continual opportunities to identify and treat risk factors for cardiovascular disease, according to Tammy Brady, MD, PhD, medical director of the Pediatric Hypertension Program and associate professor of pediatrics at Johns Hopkins University.

Transcript

What is the role of the pediatric nephrologist on the care team when treating children with metabolic syndrome?

When I think about metabolic syndrome, I like to instead think about it as cardiovascular disease risk factors, because when you use that terminology and you think of it in that way, it becomes a little more clear how important pediatric nephrology is in the treatment of metabolic syndrome per se. All of those component risk factors of the metabolic syndrome—obesity, hypertension, dyslipidemia, and insulin resistance—are all associated with accelerated atherosclerosis and ultimately with cardiovascular outcomes. In pediatric nephrology, sudden cardiac death is the leading cause of mortality in children with kidney disease, so we really as peds nephrologists have a responsibility to screen for these cardiovascular disease risk factors and work on treating them aggressively and early.

I think within pediatric nephrology we have a great opportunity for frequent engagement with the families and the patients because we see these children longitudinally. Many of us have the privilege of caring for children from infancy to adulthood, and those relationships can be pretty intense with lots of follow-up, so lots of opportunity again to screen for and treat those cardiovascular disease risk factors, which could really make a big difference long-term in their both pediatric health but also in terms of outcomes as they become adults.

Another thing to be mindful of is that one of the biggest things we get referred as a pediatric nephrologist is hypertension, and with hypertension it often comes comorbid with obesity, and with that you often will see dyslipidemia as well as insulin resistance. And so as a pediatric nephrologist getting a new referral for hypertension, it’s important for us to remember this and to screen for those cardiovascular disease risk factors, which helps you risk-stratify the patient and really helps to optimize their health, again both in the pediatric period as well as in adulthood. We know that those cardiovascular disease risk factors, when they’re present in childhood, they’re much more likely to be present in adulthood, and it’s in adulthood where you have those cardiac events.

Also, a lot of the conditions that we treat as pediatric nephrologists, these chronic long-term conditions, require medications that can have side effects that increase your cardiovascular risk. Many of the medications that we rely on can lead to increased weight, increased blood pressure, elevated glucose, as well as dyslipidemia. And so as we prescribe these, we really need to be vigilant to screen for these risk factors and also treat them as they become apparent or become manifest.

As a pediatric nephrologist, a lot of our focus is on cardiovascular health promotion, treating these risk factors to avoid cardiac end points, but newer evidence is coming out that a lot of these risk factors also lead to accelerated kidney disease or kidney disease progression and ultimately even end-stage renal disease, so as a pediatric nephrologist we really have a unique opportunity to make a real big difference in the ultimate health of these children as they become adults.

 
Copyright AJMC 2006-2019 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up