Endothelial dysfunction in the nephrotic syndrome

The nephrotic syndrome is associated with an increased risk ofatherosclerosis and endothelial dysfunction. Endothelial dysfunction was assessed and correlated with dyslipidemia and markers of inflammation in patients with nephrotic syndrome. 20 patients were divided into two groups: group A (10 patients with primary nephrotic syndrome) and group B, 10 controls. The endothelial function was assessed by means of flow mediated dilation on brachial artery, using B-mode ultrasonography. The values of flow mediated dilation were 4 +/- 1.49% (group A) and 11.95 +/- 0.24% (group B), p<0.01. There was a very strong inverse correlation between flow mediated dilation and LDL-cholesterol (r=-0.9650, p<0.001), total cholesterol (r=-0.9399, p<0.001), and fibrinogen (r=-0.7127, p<0.001), and a weak correlation with triglycerides (r=-0.2880. p<0.01), and positive correlation with respective HDL-cholesterol (r=0.4020, p<0.001). The most important factors involved in the endothelial dysfunction in the nephrotic syndrome are LDL-cholesterol, total cholesterol and fibrinogen and their treatment is necessary to prevent atherosclerosis in patients with nephrotic syndrome.