Chronic kidney disease (CKD) in children is irreversible. It is associated with renal failure progression and atherosclerotic
cardiovascular (CV) abnormalities. Nearly 60% of children with CKD are affected since birth with congenital or inherited kidney
disorders. Preliminary evidence primarily from adult CKD studies indicates common genetic risk factors for CKD and atherosclerotic
CV disease. Although multiple physiologic pathways share common genes for CKD and CV disease, substantial evidence supports
our attention to the renin angiotensin system (RAS) and the interlinked inflammatory cascade because they modulate the progressions
of renal and CV disease. Gene polymorphisms in the RAS-cytokine pathway, through altered gene expression of inflammatory cytokines,
are potential factors that modulate the rate of CKD progression and CV abnormalities in patients with CKD. For studying such
hypotheses, the cooperative efforts among scientific groups and the availability of robust and affordable technologies to
genotype thousands of single nucleotide polymorphisms (SNPs) across the genome make genome-wide association studies an attractive
paradigm for studying polygenic diseases such as CKD. Although attractive, such studies should be interpreted carefully, with
a fundamental understanding of their potential weaknesses. Nevertheless, whole-genome association studies for diabetic nephropathy
and future studies pertaining to other types of CKD will offer further insight for the development of targeted interventions
to treat CKD and associated atherosclerotic CV abnormalities in the pediatric CKD population.
Keywords Chronic kidney disease - Cardiovascular disease - Genetic - Cytokine - Polymorphism - Progression - Pediatric