A study on intima- media thickness of carotid artery in children with nephrotic syndrome: a cross sectional study

Abstract

Introduction: Atherosclerosis is one of the complications of Nephrotic syndrome. It is due to frequent exposure to hyperlipidemia, hypertension, and hypoproteinemia, steroid and immunosuppressive therapy may also contribute to the risk for cardiovascular diseases. Objective: To evaluate intima-media thickness of carotid artery in children with nephrotic syndrome. Design: A cross sectional study. Setting: The study was done in Nehru hospital of B.R.D Medical College Gorakhpur (U.P.) from June 2014-March 2015. Material & Methods: Total 150 children divided in to study group (n1=50) and control group II (n2=100). (n1=50) children with history of nephrotic syndrome enrolled in this study. The Inclusion criteria were nephrotic syndrome with normal serum complement, being on therapy for nephrotic syndrome (continuous or interrupted) for at least one year, glomerular filtration rate more than 90 ml/ min/ 1.73 m 2 and age above two years at the time of study. (N2=100) healthy age, sex weight, height and RBS matched children considered as control group. The cIMT was evaluated in nephrotic children. Chi square test was used to test difference among study and control groups. A P value less than 0.05 was considered statistically significant. Result: In the study group (n1=50) steroid resistant, steroid dependent, steroid sensitive and infrequent relapse nephrotic syndrome included one-fourth each. The mean cIMT (mm) in nephrotic children was 0.42(±0.14) while mean cIMT in control was 0.34 (±0.06) and (p <0.0014). Subsequently, the factor that influenced on thickness of cIMT were BMI, SBP, DBP, Total cholesterol, VLDL, LDL, TGs, serum protein ((p<0.05) and duration of disease (r=0.83). Conclusion: cIMT was thicker in nephrotic children, were influenced by the factor that increases thickness of cIMT were hyperlipidemia, hypertension, hypoproteinemia and duration of disease.

Evaluation of carotid intima media thickness in children with idiopathic nephrotic syndrome

“…Also, Mehta et al [26] found no correlation of CIMT with LDL, HDL, triglyceride, and VLDL, however a statistically insigni cant negative correlation with total serum cholesterol was found. However, other studies [10,22,31] found that total serum cholesterol, LDL cholesterol, and serum triglyceride level had positive and signi cant correlation with CIMT.…”

“…However, CIMT was not correlated to systolic blood pressure. Chaubey et [22] showed a signi cant positive correlation between systolic blood pressure, diastolic blood pressure and CIMT.…”

“…However, Paripović et al [20] found no differences in both mean systolic and diastolic blood pressure between the two groups. Hooman et al [21] and Chaubey et al [22] found signi cantly higher both mean systolic and diastolic blood pressure in patients than controls.…”

Assessment of Carotid Intima Media Thickness and Left Ventricular Mass Index in Children with Idiopathic Nephrotic Syndrome

“…Other factors as hypertension, renal insufficiency, and corticosteroids treatment may also contribute to the development of cardiovascular diseases(CVD). 3 Despite hyperlipidemia is often intermittent and temporary in steroid-sensitive nephrotic syndrome (SSNS); yet, dyslipidemia along with other abnormalities might be persistent in patients suffering frequently relapsing (FRNS) or steroid-resistant (SRNS) nephrotic syndrome. 4 Ultrasound assessment of the carotid intima media thickness (CIMT) was used as a marker of atherosclerosis of the coronary arteries.…”