Plasma and Urinary Platelet Factor 4 as Biomarkers for Cardiovascular Risk in Children with Chronic Kidney Disease

Area of Science:

• Pediatric Nephrology
• Cardiovascular Research
• Biomarker Discovery

Background:

• Children with chronic kidney disease (CKD) face elevated risks of cardiovascular disease (CVD).
• Early detection of subclinical CVD in pediatric CKD is crucial for reducing long-term mortality.
• Plasma factor 4 (PF4), a chemokine from activated platelets, is investigated for its role in CVD risk.

Purpose of the Study:

• To investigate the association between plasma and urinary PF4, its normalized ratio, and fractional excretion with CVD risk markers in pediatric CKD patients.
• To determine if PF4 levels can predict abnormal ambulatory blood pressure monitoring (ABPM) profiles.
• To explore the relationship between PF4 and the L-arginine/asymmetric dimethylarginine ratio.

Main Methods:

• Studied 139 children (3-18 years) with CKD stages G1-G4.
• Measured plasma and urine PF4, kidney function normalized ratios, and fractional excretion.
• Assessed cardiovascular surrogate markers including LVMI, cIMT, PWV, and ABPM profiles.

Main Results:

• Significant negative correlations found between plasma PF4 and CVD markers (LVMI, cIMT, PWV).
• Lower plasma PF4/creatinine ratio associated with higher daytime and 24-h blood pressure, high BP load, and non-dipping status.
• Plasma PF4 and PF4/Cr ratio independently predicted abnormal ABPM profiles and correlated negatively with the L-arginine/ADMA ratio.

Conclusions:

• Plasma PF4 and its ratio to creatinine are linked to CVD risk markers in pediatric CKD.
• PF4-related biomarkers may aid in predicting CVD events and CKD progression in children.
• Further research is warranted to evaluate PF4's clinical utility in pediatric CKD management.