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Endothelin-1 in children with acute poststreptococcal glomerulonephritis and hypertension
Polyxeni Nicolaidou1, Helen Georgouli, Yiannis Matsinos
1First Pediatric Department, Athens University Medical School, Aghia Sophia Children's Hospital, Athens, Greece. chrousge@med.uoa.gr
Insights
Elevated plasma endothelin-1 (ET-1) levels were observed in children with acute poststreptococcal glomerulonephritis (APSGN). Higher ET-1 concentrations correlated with increased blood pressure, suggesting a role in APSGN-related hypertension.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Physiology
- Endocrinology
Background:
- Endothelin-1 (ET-1) is a potent vasoconstrictor implicated in arterial hypertension.
- Increased ET-1 production is suspected in acute poststreptococcal glomerulonephritis (APSGN) due to endothelial damage, platelet activation, and thrombin generation.
- This study investigates ET-1 levels in children with APSGN.
Purpose of the Study:
- To determine if plasma ET-1 levels are elevated in children diagnosed with APSGN.
- To explore the relationship between plasma ET-1 concentrations and blood pressure in these children.
Main Methods:
- Evaluated 18 children with APSGN and 14 healthy controls.
- Measured plasma ET-1, atrial natriuretic peptide (ANP), renin (Rn), serum aldosterone (Aldo), creatinine clearance (Ccr), and fractional excretion of sodium (FENa).
Main Results:
- Plasma ET-1 concentrations were significantly higher in APSGN patients (3.39 pg/mL) compared to controls (1.40 pg/mL).
- Patients with APSGN exhibited elevated plasma ANP and lower plasma renin levels than controls.
- A positive correlation was found between plasma ET-1 levels and both systolic and diastolic blood pressure.
Conclusions:
- Increased plasma ET-1 concentrations appear to play a significant role in the development of hypertension in children with APSGN.
- These findings highlight ET-1 as a potential factor in the pathophysiology of hypertension associated with APSGN.
Background:
Endothelin-1 (ET-1), the most potent vasoconstrictor peptide, is known to play a role in arterial hypertension. In patients with acute poststreptococcal glomerulonephritis (APSGN) an increase in the production of ET-1 is suspected due to damaged endothelium, platelet activation and increased thrombin production in the glomeruli. The aim of the present study was to investigate whether the levels of plasma ET-1 are elevated in children with APSGN. Furthermore, we examined the association between plasma ET-1 levels and blood pressure levels in the same children.
Methods:
We studied 18 children (14 boys) with APSGN (mean age 7.44 to approximately 2.82 years). Fourteen healthy children served as controls. The following parameters were evaluated: plasma ET-1, plasma atrial natriuretic peptide (ANP), plasma renin (Rn), serum aldosterone (Aldo), creatinine clearance (Ccr) and fractional excretion of sodium (FENa).
Results:
The mean plasma ET-1 concentrations were higher in patients with APSGN (3.39 to approximately 1.86 pg/mL) compared to controls (1.40 to approximately 0.15 pg/mL; P=0.0001). Patients with APSGN also had higher plasma ANP concentrations (41.67 to approximately 27.99 pg/mL) than the controls (22.80 to approximately 4.24 pg/mL; P=0.011). Plasma Rn concentrations were lower in patients (24.54 to approximately 16.34 microU/mL) compared to controls (56.76 to approximately 32.36 microU/mL; P=0.027). A positive correlation was found between ET-1 plasma concentrations and the height of systolic or diastolic blood pressure (r=0.57, P=0.013 and r=0.53, P=0.023, respectively).
Conclusions:
Our results suggest that increased plasma ET-1 concentrations may play an important role in the pathogenesis of hypertension in children with acute poststreptococcal glomerulonephritis.