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Brachial artery flow-mediated dilatation and carotid intima medial thickness in pediatric nephrotic syndrome: a cross-sectional case–control study

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Abstract

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.

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Acknowledgments

The study was supported by an intramural funding from the authors’ institution, which is gratefully acknowledged.

Conflict of interest

None stated.

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Authors and Affiliations

  1. Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605006, India

    Illaparambath Rahul, Sriram Krishnamurthy & Niranjan Biswal

  2. Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India

    Santhosh Satheesh

  3. Department of Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India

    Zachariah Bobby

  4. Department of Community Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India

    Subitha Lakshminarayanan

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  1. Illaparambath Rahul
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  2. Sriram Krishnamurthy
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  3. Santhosh Satheesh
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  4. Niranjan Biswal
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Correspondence to Sriram Krishnamurthy.

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Rahul, I., Krishnamurthy, S., Satheesh, S. et al. Brachial artery flow-mediated dilatation and carotid intima medial thickness in pediatric nephrotic syndrome: a cross-sectional case–control study. Clin Exp Nephrol 19, 125–132 (2015). https://doi.org/10.1007/s10157-014-0958-1

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  • DOI: https://doi.org/10.1007/s10157-014-0958-1

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