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Updated: Sep 28, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Assessment of vascular and endothelial function in Kawasaki disease
Mao-Hung Lo1, Ying-Jui Lin1, Hsuan-Chang Kuo1
1Department of Pediatrics, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Insights
Kawasaki disease patients, particularly those with coronary artery aneurysms (CAA), exhibit impaired endothelial function. Flow-mediated dilation (FMD) is a key indicator for monitoring long-term endothelial health in these individuals.
Area of Science:
- Pediatric Cardiology
- Vascular Biology
- Rheumatology
Background:
- Kawasaki disease (KD) is an acute febrile vasculitis.
- Previous KD patients face elevated risks for coronary artery aneurysms (CAA) and premature arteriosclerosis.
- Endothelial dysfunction is an early indicator of arteriosclerosis.
Purpose of the Study:
- To investigate endothelial function in patients with a history of Kawasaki disease.
- To compare endothelial function between KD patients with and without CAA.
- To identify clinical characteristics associated with endothelial dysfunction in KD survivors.
Main Methods:
- A case-control study involving childhood KD patients (with and without CAA) and healthy controls.
- Assessment of anthropometric measurements, metabolic markers, and vascular ultrasonography (arterial stiffness, flow-mediated dilation [FMD]).
- Non-parametric and chi-square/Fisher's exact tests for data analysis.
Main Results:
- Seventy KD patients (median age 12.95 years) and 14 controls were studied.
- Significantly lower FMD was observed in the CAA group compared to controls (p=0.049).
- The CAA group showed a higher prevalence of impaired FMD and larger coronary segments; other markers were not significantly different.
Conclusions:
- KD patients, especially those with CAA, may experience impaired endothelial function.
- Flow-mediated dilation (FMD) is a potential marker for endothelial dysfunction in long-term KD follow-up.
- Early detection and monitoring of endothelial function are crucial for managing KD sequelae.
Background:
Kawasaki disease (KD) is an acute febrile vasculitis. Patients with previous KD have increased risk of coronary arterial aneurysms (CAA) and early-onset arteriosclerosis. Endothelial dysfunction is the earliest manifestation of arteriosclerosis. We aimed to explore the endothelial function and clinical characteristics of patients with previous KD.
Methods:
In this case-control study, we investigated childhood KD patients, with and without CAA, and a group of healthy controls. We obtained the anthropometric measurements, metabolic markers, vascular ultrasonography evaluating arterial stiffness and flow-mediated dilatation (FMD), and clinical information obtained by reviewing the patients' charts. Continuous variables were compared using non-parametric analyses and categorical variables, using the chi-square or Fisher's exact tests.
Results:
Seventy KD patients (median current age, 12.95 years; median follow-up duration, 10.88 years) and 14 healthy controls were recruited. FMD was significantly lower in the CAA group (n = 15) than the control group (FMDs: 5.59% [interquartile range, 3.99-6.86%] vs. 7.49% [5.96-9.42%], p = 0.049; diastolic FMD: 6.48% [4.14-7.32%] vs. 7.87% [6.19-9.98%], p = 0.042). The CAA group had a higher percentage of impaired FMD and the significantly largest coronary segments of the three groups. Other parameters including metabolic markers, carotid intima-media thickness, and arterial stiffness were not statistically different.
Conclusion:
KD patients, especially those with CAAs, may have impaired endothelial function. FMD may be a good indicator of endothelial dysfunction for use in long-term follow-up of KD patients.
