Clinical and experimental nephrology · 2014
Brachial artery flow-mediated dilatation and carotid intima medial thickness in pediatric nephrotic syndrome: a cross-sectional case-control study.
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Rahul Illaparambath, Krishnamurthy Sriram, Satheesh Santhosh, Biswal Niranjan, Bobby Zachariah, Lakshminarayanan Subitha
Аннотация
BACKGROUND: Children with nephrotic syndrome (NS) have hyperlipidemia, which may lead to endothelial dysfunction. This study evaluated endothelial function and structural atherosclerosis in NS children with disease duration more than 2 years, by assessment of brachial artery flow-mediated dilatation (FMD) and carotid intima medial thickness (CIMT).
METHODS: This is a cross-sectional case-control study recruiting 32 subjects aged 1-13 years with NS and 32 matched controls. Clinical details, FMD and CIMT were recorded. Lipid profile and oxidative stress were also analyzed in the subjects.
RESULTS: The proportionate change in FMD was significantly lower in cases (5.65 ± 6.08 %) compared to controls (15.21 ± 9.41 %) (p < 0.01). No significant differences in CIMT were observed (p = 0.383). Blood malondialdehyde was significantly higher (p = 0.006) in the cases. Overall, 25 NS children (78 %) were in remission for more than 6 months, and in them, 9 (36 %) had deranged lipid profile. On stepwise linear regression, age of the patient was found to be a determinant of FMD (model R (2) = 18.9 %, p value = 0.048).
CONCLUSION: The significantly low proportionate change in FMD in NS children suggests an ongoing process of endothelial dysfunction. Further studies are needed to confirm these findings. A long-term follow-up of children with NS may be required for identification of CIMT derangements.
METHODS: This is a cross-sectional case-control study recruiting 32 subjects aged 1-13 years with NS and 32 matched controls. Clinical details, FMD and CIMT were recorded. Lipid profile and oxidative stress were also analyzed in the subjects.
RESULTS: The proportionate change in FMD was significantly lower in cases (5.65 ± 6.08 %) compared to controls (15.21 ± 9.41 %) (p < 0.01). No significant differences in CIMT were observed (p = 0.383). Blood malondialdehyde was significantly higher (p = 0.006) in the cases. Overall, 25 NS children (78 %) were in remission for more than 6 months, and in them, 9 (36 %) had deranged lipid profile. On stepwise linear regression, age of the patient was found to be a determinant of FMD (model R (2) = 18.9 %, p value = 0.048).
CONCLUSION: The significantly low proportionate change in FMD in NS children suggests an ongoing process of endothelial dysfunction. Further studies are needed to confirm these findings. A long-term follow-up of children with NS may be required for identification of CIMT derangements.