Hyperlipidemia, oxidative stress, and intima media thickness in children with chronic kidney disease
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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.
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).
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.
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.
KeywordsOxidative stress Hyperlipidemia Paraoxonase Intima media thickness
- 4.Litwin M, Wuhl E, Jourdan C, Trelewicz J, Niemirska A, Fahr K, Jobs K, Grenda R, Wawer ZT, Rajszys P, Troger J, Mehls O, Schaefer F (2005) Altered morphologic properties of large arteries in children with chronic renal failure and after renal transplantation. Am Soc Nephrol 16:1494–1500CrossRefGoogle Scholar
- 7.Wilson PWF, Larson MG, Castelli WP (1994) Triglycerides, HDL cholesterol and coronary artery disease: a Framingham update on their interrelations. Can J Cardiol 10:5–9Google Scholar
- 12.Kotur-Stevuljevic J, Memon L, Stefanovic A, Spasic S, Spasojevic-Kalimanovska V, Bogavac-Stanojevic N, Kalimanovska-Ostric D, Jelić-Ivanovic Z, Zunic G (2007) Correlation of oxidative stress parameters and inflammatory markers in coronary artery disease patients. Clin Biochem 40:181–187PubMedCrossRefGoogle Scholar
- 17.Hamidi Alamdari D, Ghayour-Mobarhan M, Tavallaie S, Reza Parizadeh M, Moohebati M, Ghafoori F, Kazemi-Bajestani SMR, Paletas K, Pegiou T, Koliakos G (2008) Prooxidant–antioxidant balance as a new risk factor in patients with angiographically defined coronary artery disease. Clin Biochem 41:375–380CrossRefGoogle Scholar
- 20.Rosito GA, Massaro JM, Hoffmann U, Ruberg FL, Mahabadi AA, Vasan RS, Ramachandran S, O’Donnell CJ, Fox CS (2008) Pericardial fat, visceral abdominal fat, cardiovascular disease risk factors and vascular calcification in a community-based sample: the Framingham Heart Study. Circulation 117:605–613PubMedCrossRefGoogle Scholar
- 27.Ikizler TA, Lara L, Pupim B, Brouillette JR, Levenhagen DK, Farmer K, Hakim RM, Flakoll PJ (2002) Hemodialysis stimulates muscle and whole body protein loss and alters substrate oxidation. Am J Physiol Endocrinol Metab 282:107–116Google Scholar
- 28.Sass C, Herbeth B, Chapel O, Siest G, Visvikis S, Zannad F (1998) Intima-media thickness and diameter of carotid and femoral arteries in children, adolescents and adults from the Stanislas cohort: Effect of age, sex, anthropometry and blood pressure. J Hypertens 16:1593–1602PubMedCrossRefGoogle Scholar