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Updated: Feb 11, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Thrombomodulin as a New Marker of Endothelial Dysfunction in Chronic Kidney Disease in Children
Dorota Drożdż1, Monika Łątka1, Tomasz Drożdż2
1Department of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College, 265 Wielicka St., 30-663 Krakow, Poland.
Insights
Thrombomodulin is a key marker for endothelial dysfunction in children with chronic kidney disease (CKD). It correlates with kidney function, oxidative stress, blood pressure, and cardiac changes, highlighting its value in assessing cardiovascular risk.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Research
- Biomarker Discovery
Background:
- Endothelial dysfunction and oxidative stress are implicated in cardiovascular disease (CVD) development in chronic kidney disease (CKD).
- Understanding these mechanisms in pediatric CKD is crucial for early risk assessment and intervention.
Purpose of the Study:
- To investigate the association between endothelial dysfunction biomarkers, oxidative stress markers, and cardiovascular risk factors in children with CKD.
- To evaluate thrombomodulin (TM) as a potential marker for endothelial dysfunction in this population.
Main Methods:
- Measured serum levels of oxidized LDL (oxLDL), protein carbonyls, urea, creatinine, cystatin C, thrombomodulin (TM), ADMA, vWF, BNP, lipids, hs-CRP, ICAM-1, and albuminuria.
- Conducted anthropometric measurements, ambulatory blood pressure monitoring, and echocardiography in 59 children (0.7-18.6 years) with CKD stages 1-5.
Main Results:
- Thrombomodulin (TM) showed strong correlations with kidney function markers (creatinine, cystatin C, eGFR) and negatively with eGFR.
- TM also correlated significantly with oxidative stress markers (oxLDL), BNP, ADMA, and 24-hour blood pressure values.
- Left ventricular mass index (LVMI) was also positively associated with TM levels.
Conclusions:
- Thrombomodulin is a valuable marker of endothelial dysfunction in pediatric CKD patients.
- TM levels are strongly influenced by kidney function, oxidative stress (oxLDL), and blood pressure, indicating its utility in assessing cardiovascular risk in children with CKD.
Abstract:
Endothelial dysfunction (ED) and oxidative stress are potential new pathomechanisms of cardiovascular diseases in patients with chronic kidney disease (CKD). The aim of the study was to assess the association between endothelial dysfunction, oxidative stress biomarkers, and cardiovascular risk factors in children with CKD. Serum oxidized LDL (oxLDL), protein carbonyl group, urea, creatinine, cystatin C, thrombomodulin, asymmetric dimethylarginine (ADMA), von Willebrand factor, brain natriuretic peptide (BNP), lipids, high sensitivity C-reactive protein, intercellular adhesion molecule-1 levels, and albuminuria were measured. Anthropometric, ambulatory blood pressure (BP) measurements and echocardiography were performed. The studied group consisted of 59 patients aged 0.7-18.6 (mean 11.1) years with stages 1 to 5 CKD. Thrombomodulin strongly correlated with creatinine (R = 0.666; p < 0.001), cystatin C (R = 0.738; p < 0.001), BNP (R = 0.406; p = 0.001), ADMA (R = 0.353; p = 0.01), oxLDL (R = 0.340; p = 0.009), 24-hour systolic (R = 0.345; p = 0.011) and mean (R = 0.315; p < 0.05) BP values, and left ventricular mass index (LVMI, R = 0.293; p = 0.024) and negatively with estimated glomerular filtration rate (R = -0.716; p < 0.001). In children with CKD, TM strongly depended on kidney function parameters, oxLDL levels, and 24-hour systolic and mean BP values. Thrombomodulin seems to be a valuable marker of ED in CKD patients, correlating with CKD stage as well as oxidative stress, BP values, and LVMI.
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