Pediatric Nephrology

, Volume 28, Issue 2, pp 295–303 | Cite as

Hyperlipidemia, oxidative stress, and intima media thickness in children with chronic kidney disease

  • Jelena Kotur-Stevuljević
  • Amira Peco-Antić
  • Slavica Spasić
  • Aleksandra Stefanović
  • Dušan Paripović
  • Mirjana Kostić
  • Dragan Vasić
  • Ana Vujović
  • Zorana Jelić-Ivanović
  • Vesna Spasojević-Kalimanovska
  • Danijela Kornic-Ristovski
Original Article

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.

Keywords

Oxidative stress Hyperlipidemia Paraoxonase Intima media thickness 

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Copyright information

© IPNA 2012

Authors and Affiliations

  • Jelena Kotur-Stevuljević
    • 1
  • Amira Peco-Antić
    • 2
    • 3
  • Slavica Spasić
    • 1
  • Aleksandra Stefanović
    • 1
  • Dušan Paripović
    • 2
    • 3
  • Mirjana Kostić
    • 3
  • Dragan Vasić
    • 2
    • 4
  • Ana Vujović
    • 1
  • Zorana Jelić-Ivanović
    • 1
  • Vesna Spasojević-Kalimanovska
    • 1
  • Danijela Kornic-Ristovski
    • 5
  1. 1.Department for Medical Biochemistry, Faculty of PharmacyUniversity of BelgradeBelgradeSerbia
  2. 2.Medical FacultyUniversity of BelgradeBelgradeSerbia
  3. 3.Department of NephrologyUniversity Children’s HospitalBelgradeSerbia
  4. 4.Vascular Surgery Clinic, Institute for Cardiovascular DiseasesClinical Centre of SerbiaBelgradeSerbia
  5. 5.Biochemical LaboratoryHealth Centre PančevoPančevoSerbia

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