Abstract
Background
The roles of dyslipidemia and oxidative stress in the early phases of atherosclerosis were tested in children with chronic kidney disease (CKD). Intima media thickness of common carotid arteries (cIMT) is used as a measure of early atherosclerosis.
Methods
Fifty-two pediatric CKD patients were enrolled in the study (10 with chronic renal failure [CRF], 22 with a renal transplant [RT], 20 with chronic hemodialysis (cHD) patients, and 36 healthy children (control group, CG). Lipid status, oxidative stress, and paraoxonase 1 (PON1) status were assessed. cIMT was measured by ultrasound, adjusted for age and sex, and presented as standard deviation scores (SDS).
Results
Children with CKD had disturbed lipid content, which was most pronounced in cHD children, with higher free cholesterol and triglycerides compared with healthy children. Oxidative stress was markedly increased (malodialdehyde [MDA, μmol/L]: CRF 1.50 ± 0.26, RT 1.55 ± 0.40, cHD 1.77 ± 0.34, CG 0.97 ± 0.33, p < 0.001) and antioxidative defense was compromised (superoxide dismutase [SOD, U/L]: CG 120 ± 21, CRF 84 ± 25, RT 93 ± 12, cHD 119 ± 37, p < 0.001). Multiple linear regression analysis showed that a model that included disease duration, blood pressure, urea, lipid, and oxidative status parameters accounted for more than 90% of the variability of cIMT-SDS.
Conclusions
Early atherosclerosis in CKD children is caused, at least in part, by dyslipidemia and oxidative stress. Monitoring of vessel wall changes, along with assessment of oxidative stress status and high density lipoprotein (HDL) functionality is necessary to ensure better therapeutic strategies for delaying atherosclerotic changes in their asymptomatic phase.
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Acknowledgements
This work was financially supported by a grant from the Ministry of Education, Science and Technological Development Republic of Serbia (Project numbers 175035 and 175079) and by COST BM0904 action. We are also grateful to Dr Steve Quarrie for his help in editing the manuscript and to Marina Baranin and Vesna Stankovic for laboratory work.
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Kotur-Stevuljević, J., Peco-Antić, A., Spasić, S. et al. Hyperlipidemia, oxidative stress, and intima media thickness in children with chronic kidney disease. Pediatr Nephrol 28, 295–303 (2013). https://doi.org/10.1007/s00467-012-2323-5
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DOI: https://doi.org/10.1007/s00467-012-2323-5