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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Pregnancy Zone Protein as an Emerging Biomarker for Cardiovascular Risk in Pediatric Chronic Kidney Disease

Wei-Ling Chen1, Wei-Ting Liao1, Chien-Ning Hsu2,3

  • 1Division of Pediatric Nephrology, Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.

Journal of Clinical Medicine
|September 28, 2023
PubMed

Insights

Pregnancy zone protein (PZP) may indicate cardiovascular disease risk in children with chronic kidney disease (CKD). Higher PZP levels correlate with arterial stiffness and blood pressure abnormalities in pediatric CKD patients, especially those with congenital anomalies of the kidney and urinary tract (CAKUT).

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Research
  • Biomarker Discovery

Background:

  • Cardiovascular disease (CVD) is a major complication in pediatric chronic kidney disease (CKD).
  • Congenital anomalies of the kidney and urinary tract (CAKUT) are the primary cause of CKD in children.
  • Early identification of CVD risk markers is critical for managing pediatric CKD patients.

Purpose of the Study:

  • To investigate plasma pregnancy zone protein (PZP) as a potential biomarker for cardiovascular risk in children with CKD.
  • To explore the association between PZP levels and cardiovascular parameters, including blood pressure, arterial stiffness, and nitric oxide (NO) bioavailability.

Main Methods:

  • Plasma PZP concentrations were analyzed in 106 children and adolescents with CKD stages G1-G4.
  • Associations between PZP and ambulatory blood pressure monitoring (ABPM) profiles, cardiac/carotid ultrasounds, arterial stiffness indices, and NO parameters were assessed.
  • Patients were stratified based on CKD etiology (CAKUT vs. non-CAKUT) and presence of ABPM abnormalities.

Main Results:

  • PZP levels positively correlated with arterial stiffness indices (beta index, pulse wave velocity) in children with CAKUT.
  • Children with CKD experiencing ABPM abnormalities and impaired night dipping showed significantly higher PZP concentrations.
  • PZP levels demonstrated a positive correlation with nitric oxide (NO) bioavailability.

Conclusions:

  • Pregnancy zone protein (PZP) may serve as a novel indicator of cardiovascular risk in pediatric CKD.
  • PZP exhibits differential associations with cardiovascular risk factors in CAKUT and non-CAKUT pediatric CKD populations.
  • This study highlights a novel relationship between PZP and cardiovascular risk in the pediatric CKD literature.

Keywords:
ambulatory blood pressure monitoringcardiovascular diseasechildrenchronic kidney diseasecongenital anomalies in the kidney and urinary tract (CAKUT)hypertensionpregnancy zone protein

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