Carotid artery function in children with idiopathic nephrotic syndrome

Nephrotic patients are prone to atherosclerosis in consequence of frequent exposures to hyperlipidemia, hypertension, and immunosuppressive drugs.

We studied the carotid parameters as early indicators of atherosclerosis in children with nephrotic syndrome.

Between 2008 and 2011, 51 children with history of nephrotic syndrome enrolled in the study. The inclusion criteria were: idiopathic nephrotic syndrome with normal serum complement, at least one year after initiation of disease, glomerular filtration rate more than 20 mL/min/1.73 m², age over two years old at the time of study. Seventy-five healthy sex-age-matched children considered as a control group. Carotid function parameters and left ventricular mass index were studied in nephrotic children.

Steroid sensitive, resistant, and dependent nephrotic syndrome included one-third each. The mean carotid intima-media thickness (mm) in nephrotic children was 0.42 (±.14) while the mean cIMT in controls was 0.37 (±.08) (p-value <.05). After log transformation, General Linear Multivariate analysis revealed significant difference of carotid intima-media thickness in nephrotic patients (p-value <.001). Subsequently, the factor that influenced on cIMT was duration of disease (P<.05). One-half of nephrotic children who had echocardiography, showed left ventricular hypertrophy. It was correlated with carotid stiffness and systolic hypertension (P<.05).

Carotid intima-media thickness was thicker in nephrotic children. Carotid parameters were influenced by duration of disease and hypertension.