The Cardiovascular Comorbidity in Children with Chronic Kidney Disease Study

The 4C Study is the largest cohort study investigating the causes and natural history of cardiovascular disease in children with chronic kidney disease on their transition to adulthood.


Why did we start this study?

Adults with chronic kidney disease are at high risk of suffering from cardiovascular events even at young age.

We started the 4C Study to tease out the factors that contribute to early cardiovascular disease development in children with chronic kidney disease.


Current study status

The 4C Study has explored the development of early cardiovascular disease in 700 children with chronic kidney disease for the past 8 years. Study participants underwent comprehensive clinical and laboratory examinations twice a year, and cardiac and vascular imaging studies once a year.



Patients already



Participating centers



European countries



Study investigators

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The simple process to continue the study

Starting from 2019 we are following study participants with annual surveys and an option to come back for cardiovascular examinations every 3 years. The study is expected to continue for 10 additional years.


Online questionnaires

Filling the survey takes no more than 20-30 minutes and yearly reminders help to stay on shedule.


Return every year


Phone interviews

Set the time for a phone interview and the investigator will fill yearly questionnaires for you.


Check-up every 3 years

Return to the clinic for a comprehensive cardiovascular investigation every 3 years.

Log in

Our results

So far the 4C Study helped us to learn a lot about the development, progression and complications of chronic kidney disease in children. The information collected in the study provides unique insights into the development of heart and vessel disease in diverse groups of children with chronic kidney disease.

More than 50+ centers

More than 50 centers from 12 European countries participate in the 4C Study

Find a center