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Assessment of Carotid Intima Media Thickness and Left Ventricular Mass Index in Children with Idiopathic Nephrotic
Heba Mostafa Ahmed1, Emad El-Deen Ameen1, Mohammad Shafiq Awad2
1Department of Pediatrics, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt.
Insights
Children with nephrotic syndrome face higher atherosclerosis risk, indicated by increased carotid intima media thickness (CIMT). Left ventricular mass (LVM) is also elevated, correlating with disease duration and cardiovascular risk factors.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Health
- Medical Research
Background:
- Nephrotic syndrome (NS) in children elevates atherosclerosis risk due to hyperlipidemia, hypertension, and immunosuppressants.
- Carotid intima media thickness (CIMT) is a key indicator of subclinical atherosclerosis.
- Proteinuria and hyperlipidemia in NS contribute to cardiac morbidity and mortality.
Purpose of the Study:
- To assess carotid intima media thickness (CIMT) in children with nephrotic syndrome.
- To evaluate left ventricular mass (LVM) in pediatric nephrotic syndrome patients.
- To determine the relationship between NS, CIMT, and LVM.
Main Methods:
- Study included 81 children with NS and 100 healthy controls.
- Inclusion criteria: NS diagnosis, disease duration ≥12 months, GFR >60mL/min/1.73m², age ≥2 years.
- Measurements: CIMT, LVM index, lipid profile, urine protein/creatinine ratio, kidney function tests.
Main Results:
- Mean CIMT was significantly higher in NS patients (0.51±0.12 mm) versus controls (0.42±0.09 mm).
- Left ventricular mass (LVM) and LVM index were significantly elevated in NS children.
- CIMT correlated with disease duration; LVM index correlated with disease duration, BMI, blood pressure, and triglycerides.
Conclusions:
- Children with NS exhibit increased atherosclerosis risk, evidenced by elevated CIMT.
- Elevated LVM in NS patients correlates positively with blood pressure, disease duration, triglyceride levels, and BMI.
- Findings highlight the increased cardiovascular risk in pediatric nephrotic syndrome.
Background:
Children with nephrotic syndrome (NS) are at a greater risk of atherosclerosis due to recurrent exposures to hyperlipidemia, hypertension, and immunosuppressive medications. CIMT (carotid intima media thickness) is a reliable marker for assessment of atherosclerosis of large and medium-sized blood vessels; endothelial dysfunction and increased CIMT usually precede the development of cardiovascular diseases. Some manifestations of NS, like proteinuria and hyperlipidemia, are associated with an increased risk of cardiac morbidity and mortality. The aim of the current study was to evaluate the carotid intima media thickness and LVM (left ventricular mass) thickness in children with nephrotic syndrome.
Subjects And Methods:
Eighty-one children with nephrotic syndrome and 100 healthy children as controls were enrolled in the study. The inclusion criteria were: disease duration of minimum of 12 months, glomerular filtration rate >60mL/min/1.73m 2 and children aged two years or more at the time of study. CIMT and left ventricular mass index, lipid profile, protein/creatinine ratio in urine and kidney function tests were done for cases and controls after approval of internal ethical committee.
Results:
The mean CIMT (mm) was significantly higher in NS (0.51± 0.12) compared to controls (0.42± 0.09) (P <0.001). LVM and LVM Index were significantly higher in NS than controls (p< 0.001, for both). Subsequently, CIMT was significantly correlated to duration of the disease (p< 0.001), LVM index was significantly correlated with duration of the disease, body mass index (BMI), blood pressures and triglycerides level (p< 0.05).
Conclusion:
Children with NS are at increasing risk to develop atherosclerosis as measured by CIMT. LVM was significantly higher in NS and positively correlated to BP, disease duration, triglyceride levels and BMI.
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