Endothelial dysfunction in children with chronic kidney disease
Background and Objective: Cardiovascular disease (CVD) is the main cause of death in children with chronic kidney disease (CKD). Inflammation and endothelial dysfunction (ED) are found in the majority of these patients and are factors associated to CVD. Flow mediated dilatation (FMD) is a surrogate...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-07-01
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| Series: | Nefrología (English Edition) |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2013251421000833 |
| _version_ | 1818398231296475136 |
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| author | Juan Antonio García-Bello Rita A. Gómez-Díaz Alicia Contreras-Rodríguez Lorena Sánchez-Barbosa Rafael Mondragón-González Juan Manuel Gallardo-Montoya Niels H. Wacher |
| author_facet | Juan Antonio García-Bello Rita A. Gómez-Díaz Alicia Contreras-Rodríguez Lorena Sánchez-Barbosa Rafael Mondragón-González Juan Manuel Gallardo-Montoya Niels H. Wacher |
| author_sort | Juan Antonio García-Bello |
| collection | DOAJ |
| description | Background and Objective: Cardiovascular disease (CVD) is the main cause of death in children with chronic kidney disease (CKD). Inflammation and endothelial dysfunction (ED) are found in the majority of these patients and are factors associated to CVD. Flow mediated dilatation (FMD) is a surrogate marker validated for evaluating ED. Our objective was to identify risk factors associated to ED in children with CKD. Materials and Methods: Children 2–16 years of age were studied. Clinical information and biochemical variables were gathered, including intact parathyroid hormone (iPTH), interleukins 6 and 1b, high sensitivity C reactive protein (hsCRP), reduced glutathione, nitric oxide, malondialdehyde and homocysteine. FMD was measured, and considered altered if <7%. Results: Included were 129 patients aged 13.1 ± 2.6 years. FMD < 7% was found in 69 (52.7%). Patients with altered FMD had higher levels of triglycerides and hsCRP than those with normal FMD (145.5 mg/dl vs. 120.0 mg/dl, P = .042, y 1.24 U/L vs. 0.55 U/L, P = .007, respectively), as well as higher frequency of low iPTH (19.1% vs. 4.9%, P = .036). Levels of hsCRP correlated significantly with FMD (Rho = −0.28, P = .003). Patients with low iPTH (OR = 4.41, 95%CI 1.13–17.27, P = .033) and increased hsCRP (OR = 2.89, 95%CI 1.16–7.17, P = .022) had higher adjusted risk of having FMD < 7%. Conclusions: Hypertriglyceridemia, inflammation and low iPTH associated significantly with altered FMD. They are frequent, treatable risk factors for CVD. Resumen: Antecedentes y Objetivo: La enfermedad cardiovascular (ECV) es la principal causa de muerte en niños con Enfermedad Renal Crónica (ERC). La inflamación y la disfunción endotelial (DE) se presenta en la mayoría de estos pacientes y son factores asociados a ECV. La dilatación mediada por flujo (DMF) <7% es un marcador subrogado validado en la evaluación de la DE. Nuestro objetivo fue identificar los factores de riesgo asociados a DE en niños con ERC. Materiales y Métodos: Se estudió a niños de 2–16 años de edad. Se recopiló su información clínica y variables bioquímicas, incluidos Hormona Paratiroidea Intacta (iPTH), interleucinas 6 y 1b, Proteína C Reactiva de alta sensibilidad (hsCRP), Glutatión reducido, óxido nítrico, malondialdehído, y homocisteína. Se consideró DMF alterada <7%. Resultados: Se incluyó a 129 pacientes con edad de 13.1 ± 2.6 años. Tuvieron DMF < 7% 69 (52.7%). Los pacientes con DMF < 7% tuvieron niveles más altos de triglicéridos y de hsCRP que aquellos con DMF ≥ 7% (145.5 mg/dl vs. 120.0 mg/dl, P = .042, y 1.24 U/L vs. 0.55 U/L, P = .007, respectivamente), así como una mayor frecuencia de iPTH baja (19.1% vs. 4.9%, P = .036). Los niveles de hsCRP se correlacionaron significativamente con la DMF (Rho = −0.28, P = .003). Los pacientes con iPTH baja (OR = 4.41, 95% CI 1.13–17.27, P = .033) y con hsCRP incrementada (OR = 2.89, 95%CI 1.16–7.17, P = .022) tuvieron un riesgo ajustado mayor de DMF < 7%. Conclusiones: La hipertrigliceridemia, la inflamación e iPTH baja se asociaron significativamente a una DMF alterada. Son factores de riesgo de ECV frecuentes y tratables. |
| first_indexed | 2024-12-14T07:01:30Z |
| format | Article |
| id | doaj.art-06ceab3ce8ed45a69e8886da5d7b3d70 |
| institution | Directory Open Access Journal |
| issn | 2013-2514 |
| language | English |
| last_indexed | 2024-12-14T07:01:30Z |
| publishDate | 2021-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Nefrología (English Edition) |
| spelling | doaj.art-06ceab3ce8ed45a69e8886da5d7b3d702022-12-21T23:12:23ZengElsevierNefrología (English Edition)2013-25142021-07-01414436445Endothelial dysfunction in children with chronic kidney diseaseJuan Antonio García-Bello0Rita A. Gómez-Díaz1Alicia Contreras-Rodríguez2Lorena Sánchez-Barbosa3Rafael Mondragón-González4Juan Manuel Gallardo-Montoya5Niels H. Wacher6División de Investigación, Unidad Médica de Alta Especialidad Hospital de Gineco Obstetricia No. 3, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, MexicoUnidad de Investigación Médica en Epidemiología Clínica, UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, Mexico; Corresponding author.Servicio de Radiodiagnóstico, Unidad Médica de Alta Especialidad Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, MexicoCoordinación de Unidades Médicas de Alta Especialidad, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, MexicoUnidad de Investigación Médica en Epidemiología Clínica, UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, MexicoEnfermedades Nefrológicas, Unidad Médica de Alta Especialidad Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, MexicoUnidad de Investigación Médica en Epidemiología Clínica, UMAE Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Ciudad de México, MexicoBackground and Objective: Cardiovascular disease (CVD) is the main cause of death in children with chronic kidney disease (CKD). Inflammation and endothelial dysfunction (ED) are found in the majority of these patients and are factors associated to CVD. Flow mediated dilatation (FMD) is a surrogate marker validated for evaluating ED. Our objective was to identify risk factors associated to ED in children with CKD. Materials and Methods: Children 2–16 years of age were studied. Clinical information and biochemical variables were gathered, including intact parathyroid hormone (iPTH), interleukins 6 and 1b, high sensitivity C reactive protein (hsCRP), reduced glutathione, nitric oxide, malondialdehyde and homocysteine. FMD was measured, and considered altered if <7%. Results: Included were 129 patients aged 13.1 ± 2.6 years. FMD < 7% was found in 69 (52.7%). Patients with altered FMD had higher levels of triglycerides and hsCRP than those with normal FMD (145.5 mg/dl vs. 120.0 mg/dl, P = .042, y 1.24 U/L vs. 0.55 U/L, P = .007, respectively), as well as higher frequency of low iPTH (19.1% vs. 4.9%, P = .036). Levels of hsCRP correlated significantly with FMD (Rho = −0.28, P = .003). Patients with low iPTH (OR = 4.41, 95%CI 1.13–17.27, P = .033) and increased hsCRP (OR = 2.89, 95%CI 1.16–7.17, P = .022) had higher adjusted risk of having FMD < 7%. Conclusions: Hypertriglyceridemia, inflammation and low iPTH associated significantly with altered FMD. They are frequent, treatable risk factors for CVD. Resumen: Antecedentes y Objetivo: La enfermedad cardiovascular (ECV) es la principal causa de muerte en niños con Enfermedad Renal Crónica (ERC). La inflamación y la disfunción endotelial (DE) se presenta en la mayoría de estos pacientes y son factores asociados a ECV. La dilatación mediada por flujo (DMF) <7% es un marcador subrogado validado en la evaluación de la DE. Nuestro objetivo fue identificar los factores de riesgo asociados a DE en niños con ERC. Materiales y Métodos: Se estudió a niños de 2–16 años de edad. Se recopiló su información clínica y variables bioquímicas, incluidos Hormona Paratiroidea Intacta (iPTH), interleucinas 6 y 1b, Proteína C Reactiva de alta sensibilidad (hsCRP), Glutatión reducido, óxido nítrico, malondialdehído, y homocisteína. Se consideró DMF alterada <7%. Resultados: Se incluyó a 129 pacientes con edad de 13.1 ± 2.6 años. Tuvieron DMF < 7% 69 (52.7%). Los pacientes con DMF < 7% tuvieron niveles más altos de triglicéridos y de hsCRP que aquellos con DMF ≥ 7% (145.5 mg/dl vs. 120.0 mg/dl, P = .042, y 1.24 U/L vs. 0.55 U/L, P = .007, respectivamente), así como una mayor frecuencia de iPTH baja (19.1% vs. 4.9%, P = .036). Los niveles de hsCRP se correlacionaron significativamente con la DMF (Rho = −0.28, P = .003). Los pacientes con iPTH baja (OR = 4.41, 95% CI 1.13–17.27, P = .033) y con hsCRP incrementada (OR = 2.89, 95%CI 1.16–7.17, P = .022) tuvieron un riesgo ajustado mayor de DMF < 7%. Conclusiones: La hipertrigliceridemia, la inflamación e iPTH baja se asociaron significativamente a una DMF alterada. Son factores de riesgo de ECV frecuentes y tratables.http://www.sciencedirect.com/science/article/pii/S2013251421000833Disfunción endotelialDilatación mediada por flujoEnfermedad cardiovascularEnfermedad renal crónica |
| spellingShingle | Juan Antonio García-Bello Rita A. Gómez-Díaz Alicia Contreras-Rodríguez Lorena Sánchez-Barbosa Rafael Mondragón-González Juan Manuel Gallardo-Montoya Niels H. Wacher Endothelial dysfunction in children with chronic kidney disease Nefrología (English Edition) Disfunción endotelial Dilatación mediada por flujo Enfermedad cardiovascular Enfermedad renal crónica |
| title | Endothelial dysfunction in children with chronic kidney disease |
| title_full | Endothelial dysfunction in children with chronic kidney disease |
| title_fullStr | Endothelial dysfunction in children with chronic kidney disease |
| title_full_unstemmed | Endothelial dysfunction in children with chronic kidney disease |
| title_short | Endothelial dysfunction in children with chronic kidney disease |
| title_sort | endothelial dysfunction in children with chronic kidney disease |
| topic | Disfunción endotelial Dilatación mediada por flujo Enfermedad cardiovascular Enfermedad renal crónica |
| url | http://www.sciencedirect.com/science/article/pii/S2013251421000833 |
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