Role of CD36 expression on circulating monocytes subsets in children on regular hemodialysis

Cardiovascular diseases are common in children with chronic kidney disease (CKD). According to studies, monocytes play a role in atherosclerotic vascular disorders. CD36 promotes the binding of oxidised low-density lipoprotein (oxLDL) on monocytes, however its role in atherosclerosis is unclear. We aimed to assess the frequency of monocyte subsets in CKD children, and to determine CD36 differential expression on monocyte subsets and its association with the risk of atherosclerotic incidents in those patients. This case-control study included 40 children with CKD and 40 apparently healthy children as controls. We investigated the frequency of total monocyte and monocyte subsets using CD14/CD16. Also, we assessed CD36 differential expression on circulating subsets using flow cytometry. In addition to Doppler ultrasound assessment of the intimal medial thickness (IMT) and peak systolic velocity (PSV) of the main arteries, with routine laboratory investigations of both groups. There was a significant increase in median values of total circulating monocyte percentage in patients than controls (P=0.001). Also, there was a significant increase in the percentage of classical monocyte (CD14high/CD16-) and non-classical monocytes subset (CD14low/CD16+) in patients when compared to controls (P=0.027) and (P=0.001), respectively. There was a significant decrease in the median values of CD36 Mean fluorescence intensity (MFI) expressed on classical, non-classical and intermediate monocytes in patients than the control group (P=0.001), (P=0.001) and (P=0.002), respectively. CD36 MFI expressed on classical, non-classical and intermediate monocytes negatively correlated with cholesterol, triglyceride, systolic, diastolic blood pressure and the IMT of the femoral artery. In conclusion, the increase in the frequency of monocytes, particularly the classical and nonclassical subsets, may be a key component in atherosclerosis pathogenesis in children on hemodialysis. Low CD36 expression on monocyte subsets may be involved in the pathogenesis of atherosclerosis in children on hemodialysis.