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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Endothelial Dysfunction in Children with Frequently Relapsing and Steroid-Dependent Nephrotic Syndrome

Rajesh Verma1, Bobbity Deepthi2, Abhijeet Saha1

  • 1Division of Pediatric Nephrology, Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India.

Indian Journal of Nephrology
|September 2, 2025
PubMed

Insights

Children with frequently relapsing or steroid-dependent nephrotic syndrome experience endothelial dysfunction during relapses. Biomarker levels decreased with treatment, indicating disease activity influences vascular health.

Area of Science:

  • Pediatric Nephrology
  • Cardiovascular Health in Children
  • Endothelial Function Research

Background:

  • Frequently relapsing (FR) and steroid-dependent (SD) nephrotic syndrome (NS) in children are linked to endothelial dysfunction and injury.
  • This dysfunction increases the risk of accelerated atherosclerosis and adverse cardiovascular events in affected children.
  • Understanding these vascular changes is crucial for managing long-term health outcomes.

Purpose of the Study:

  • To investigate plasma levels of endothelial dysfunction markers, soluble E-selectin (sE-selectin) and vascular cell adhesion molecule-1 (VCAM-1), in children with FRNS and SDNS during relapse.
  • To compare these marker levels in children with FRNS/SDNS during relapse and remission against healthy controls.

Main Methods:

  • Fifty-six children (aged 1-16 years) diagnosed with FRNS or SDNS were enrolled at the time of relapse.
  • Plasma samples were collected during relapse and followed up to six weeks post-steroid-induced remission.
  • Levels of sE-selectin and VCAM-1 were measured and compared between patients and an equal number of controls.

Main Results:

  • Plasma sE-selectin and VCAM-1 levels were significantly elevated in children with FRNS/SDNS during relapse (p < 0.0001).
  • These marker levels decreased significantly after six weeks of steroid-induced remission, becoming comparable to control levels.
  • Elevated serum total cholesterol and triglycerides were observed during relapse and persisted even after remission compared to controls (p < 0.0001).

Conclusions:

  • Endothelial dysfunction is confirmed in children with FRNS and SDNS during relapse.
  • The degree of endothelial dysfunction appears to be largely dependent on the activity of the nephrotic syndrome.
  • These findings highlight the importance of monitoring cardiovascular risk factors in children with FRNS/SDNS.
Abstract

Keywords:
Endothelial dysfunctionSDNSVCAM-1sE-selectin

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