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Hydrogen Sulfide-to-Thiosulfate Ratio Associated with Blood Pressure Abnormalities in Pediatric CKD

Chien-Ning Hsu1,2, Wei-Ling Chen3, Wei-Ting Liao3

  • 1Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan, China.

Journal of Personalized Medicine
|August 26, 2022
PubMed

Insights

Children with chronic kidney disease (CKD) have high cardiovascular disease (CVD) risk. The H2S-to-thiosulfate ratio, not individual levels, correlated with CVD risk markers like blood pressure in pediatric CKD patients.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Disease Research
  • Biochemistry

Background:

  • Cardiovascular disease (CVD) is a major concern in children with chronic kidney disease (CKD), necessitating early risk identification and intervention.
  • Hydrogen sulfide (H2S), a signaling molecule, and its metabolite thiosulfate are implicated in both CKD and CVD.
  • The interplay between H2S, thiosulfate, and CVD risk markers in pediatric CKD is not well understood.

Purpose of the Study:

  • To investigate the associations of circulating hydrogen sulfide (H2S), thiosulfate, and their ratio with cardiovascular disease (CVD) risk markers in children and adolescents with chronic kidney disease (CKD).
  • To explore potential differences in these associations based on CKD stage and blood pressure abnormalities.

Main Methods:

  • Cross-sectional study involving 56 children and adolescents (aged 6-18 years) with CKD stages G1-G4.
  • 24-hour ambulatory blood pressure monitoring (ABPM) was used to assess blood pressure load.
  • Measurements included circulating H2S, thiosulfate levels, carotid artery intima-media thickness (cIMT), and left ventricular (LV) mass.

Main Results:

  • Two-thirds of pediatric CKD patients exhibited elevated blood pressure load on ABPM, even in early stages.
  • Children with ABPM abnormalities showed a higher H2S-to-thiosulfate ratio.
  • The H2S-to-thiosulfate ratio positively correlated with 24-hour systolic blood pressure (SBP), nighttime SBP, and cIMT. H2S was negatively associated with LV mass, and thiosulfate was positively associated with 24-hour diastolic blood pressure (DBP) after confounder adjustment.

Conclusions:

  • Circulating H2S, thiosulfate, and their ratio exhibit differential associations with CVD risk markers in pediatric CKD.
  • The H2S-to-thiosulfate ratio appears more strongly linked to hypertension and arterial stiffness than individual components.
  • Further research is warranted to explore the therapeutic potential of modulating the H2S signaling pathway for CVD prevention in childhood CKD.

Keywords:
ambulatory blood pressure monitoringcardiovascular diseasechildrenchronic kidney diseasehydrogen sulfidehypertensionnitric oxidethiosulfate

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