Cardiovascular risk assessment in children with chronic kidney disease

Shroff, Rukshana; Dégi, Arianna; Kerti, Andrea; Kis, Éva; Cseprekál, Orsolya; Tory, Kálmán; Szabó, Attila; Reusz, György

doi:10.1007/s00467-012-2325-3

Cited by 54 publications

(32 citation statements)

References 73 publications

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“…Those with CKD or ESRD develop intimal atherosclerosis similar to the general population for whom the traditional risk factors of hypertension, dyslipidemia, insulin resistance, and obesity play major roles. However, unlike the general population, the CKD/ESRD population also develops arteriosclerotic disease with medial calcifications in which nontraditional risk factors unique to the uremic milieu may play a more important role, particularly as CKD progresses [85][86][87].…”

Section: Pharmacologic Managementmentioning

confidence: 99%

Etiology and management of dyslipidemia in children with chronic kidney disease and end-stage renal disease

Khurana

Silverstein

2015

Pediatr Nephrol

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Lipids are essential components of cell membranes, contributing to cell fuel, myelin formation, subcellular organelle function, and steroid hormone synthesis. Children with chronic kidney disease (CKD) and end-stage renal disease (ESRD) exhibit various co-morbidities, including dyslipidemia. The prevalence of dyslipidemias in children with CKD and ESRD is high, being present in 39-65 % of patients. Elevated lipid levels in children without renal disease are a risk factor for cardiovascular disease (CVD), while the risk for CVD in pediatric CKD/ESRD is unclear. The pathogenesis of dyslipidemia in CKD features various factors, including increased levels of triglycerides, triglyceride-rich lipoproteins, apolipoprotein C3 (ApoC-III), decreased levels of cholesterylester transfer protein and high-density lipoproteins, and aberrations in serum very low-density and intermediatedensity lipoproteins. If initial risk assessment indicates that a child with advanced CKD has 2 or more co-morbidities for CVD, first-line treatment should consist of nonpharmacologic management such as therapeutic lifestyle changes and dietary counseling. Pharmacologic treatment of dyslipidemia may reduce the incidence of CVD in children with CKD/ESRD, but randomized trials are lacking. Lipids are essential components of cell membranes, contributing to cell fuel, myelin formation, subcellular organelle function, and steroid hormone synthesis. Lipids are generally categorized by their density and other physical characteristics [1]. Since lipids such as cholesterol and triglycerides (TG) are insoluble in plasma, lipoproteins are required to transport all sources (e.g., diet) of lipids to areas in which the lipids can either be stored for future use or used immediately [2], although it should be noted that short-and medium-chain fatty acids also flow via the portal system as fatty acids. Specifically, low-density lipoproteins (LDL) carry the majority of cholesterol (forming LDL-C), while very low-density lipoproteins (VLDL) carry the majority of triglycerides.The broad categories of lipoproteins are chylomicrons, VLDL, LDL, and high-density lipoproteins (HDL Prevalence and sub-types of dyslipidemia in pediatric chronic kidney disease (CKD) and end-stage renal disease (ESRD)Children with CKD/ESRD exhibit various co-morbidities, including dyslipidemia. The prevalence of dyslipidemias in children with CKD and ESRD is high (39-65 %), but is significantly dependent on the cause and vintage of CKD (e.g., usually more common and severe with glomerular disease and proteinuria) and the stage of the disease [4,5]. The Chronic Kidney Disease in Children (CKiD) study included an assessment of the relationship between renal function and serum lipid levels. The most common type of dyslipidemia was hypertriglyceridemia. They found an inverse relationship between renal function (measured glomerular filtration rate, or GFR) and serum TG and total cholesterol (TC) levels; that is, as GFR declines, TG and TC levels generally increase. Conversely, there is a ...

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Section: Pharmacologic Managementmentioning

confidence: 99%

Etiology and management of dyslipidemia in children with chronic kidney disease and end-stage renal disease

Khurana

Silverstein

2015

Pediatr Nephrol

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“…In this project, PWV was calculated by SphygmoCor software (AtCor Medical, Sydney, Australia) using the intersecting tangent algorithm. The pulse travel distance was calculated as the distance from the suprasternal notch to the recording point at the femoral artery via the umbilicus minus the distance from the suprasternal notch to the recording point at the carotid artery [30].…”

Section: Measurement Of Pulse Wave Velocitymentioning

confidence: 99%

The vascular phenotype of children with systemic lupus erythematosus

et al. 2015

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“…The homeostasis model assessment of insulin resistance (HOMA-IR) was calculated as fasting serum insulin (μU/ml) x FPG (mmol/l)/22.5 and used as an index of insulin resistance. HOMA-IR scores ≥2.5 shows insulin resistance (7). An oral glucose tolerance test was performed (1.75 g of glucose/1 kg; glucose/insulin measured at baseline, 1 st h and 2 nd h) in obese subjects.…”

Section: Methodsmentioning

confidence: 99%

“…Hsp70 binds to surface receptors on immune and epithelial cells and trigger an immune-inflammatory response (5). Matrix Gla [γ-carboxyglutamic acid] protein (MGP) is an extracellular vitamin K-dependent matrix protein and a potent inhibitor of vascular calcification (7). MGP is related to extracellular matrix binding and apoptosis, as well as tissue growth and development (8).…”

Section: Introductionmentioning

confidence: 99%

Serum Heat Shock Protein 70, S100A12 and Matrix Gla Protein in Childhood Obesity and Metabolic Syndrome

Can¹,

Buyukınan²,

Güzelant³

et al. 2016

Van Med J

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Objectives:The primary cause of the metabolic syndrome appears to be obesity that is associated with a low-grade inflammatory state resulting from insulin resistance in both adult and pediatric populations. Heat shock protein 70, S100A12 and matrix Gla protein are involved in chronic inflammatory diseases. We aimed to evaluate the association between these markers and childhood obesity and metabolic syndrome. Materials and Methods:This study was performed with 45 obese children aged 10-15 years and 47 children with metabolic syndrome aged 10-15 years. Serum heat shock protein 70, S100A12 and matrix Gla protein levels were measured by using ELISA method.Results: Serum matrix Gla protein and S100A12 levels in obese subjects were significantly higher than metabolic syndrome groups (p<0.05). However no significant differences were observed in serum high sensitivity Creactive protein (p=0.288) and heat shock protein 70 (p=0.960) levels between metabolic syndrome and obese subjects. There was a significant positive correlation between serum S100A12, matrix Gla protein and heat shock protein 70 levels in both groups. Conclusions:Our findings showed a significant association between heat shock protein 70, S100A12, matrix Gla protein, and obesity and metabolic syndrome. Obesity may be involved in increased risk of developing metabolic syndrome. It might be useful to focus on the roles of these proteins in obesity in accordance with the prevention of the development of metabolic syndrome and other metabolic disorders like diabetes.Key Words: Obesity, metabolic syndrome, heat shock protein 70, S100A12 and matrix Gla protein ÖZET Amaç: Metabolik Sendromun primer nedeni erişkin ve çocuk popülasyonunda insülin rezistansı ile sonuçlanan düşük dereceli inflamasyon ile ilgili obezitedir. Heat şok protein 70,S100A12 ve matriks Gla protein kronik inflamatuar hastalık ile ilgilidir. Çocuk çağı obezitesi ve metabolik sendromun da bu markırları değerlendirmeyi amaçladık. Gereç ve Yöntem:Bu çalışma 10-15 yaş aralığında 45 obez çocuk ve 47 metabolik sendrom'lu çocukta yapıldı. Heat şok protein 70, S100A12 ve matriks Gla protein ELISA metodu kullanılarak ölçüldü. Bulgular:Obez çocuklarda serum matriks Gla protein ve S100A12 seviyeleri metabolik sendrom'lu gruptan anlamlı olarak yüksekti (p<0.05). İlaveten, metabolik sendrom ve obez bireyler arasında serum hsCRP (p=0.288) ve heat şok protein 70 (p=0.960) fark yoktu. Her iki grupta S100A12, matriks Gla protein ve heat şok protein 70 seviyeleri arasında anlamlı pozitif korelasyon vardı.Sonuç: Bulgularımız S100A12, matriks Gla protein ve heat şok protein 70 biyomarkırları metabolik sendrom ve obezite ile anlamlı olarak ilgili olduğunu gösterdi. Obezite metabolik sendrom gelişiminde önemli bir risk faktörüdür. Obezitede bu proteinlerin artışı, metabolik sendrom ve diabet gibi metabolik bozuklukların gelişiminin önlenmesinde ilgi çekici olabilir.

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Cardiovascular risk assessment in children with chronic kidney disease

Cited by 54 publications

References 73 publications

Etiology and management of dyslipidemia in children with chronic kidney disease and end-stage renal disease

Etiology and management of dyslipidemia in children with chronic kidney disease and end-stage renal disease

The vascular phenotype of children with systemic lupus erythematosus

Serum Heat Shock Protein 70, S100A12 and Matrix Gla Protein in Childhood Obesity and Metabolic Syndrome

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