Carotid intima media thickness in children with nephrotic syndrome: an observational case control study

Abstract

Carotid intima media thickness (cIMT) is considered as a surrogate marker for the various cardiovascular events that complicate nephrotic syndrome (NS). The present work was conducted to study cIMT in children with NS and to find out its correlation with dyslipidemia and other risk factors. This was a case control study conducted at a tertiary care hospital in children with NS who were more than 2 years with normal serum complement, being on therapy for NS for at least 1 year, glomerular filtration rate more than 90 ml/minute/1.73 m 2 and absence of acute infection in previous 3 months. Sixty six children with NS constituted the case material and 128 age and sex matched children were taken as control. The mean age in case and control cohort was 6.71 ± 3.3 and 7.89 ± 3.95 years, respectively. The mean age of onset of illness was 4.32 ± 2.25 years. The mean duration of illness was 2.39 ± 1.44 years. Thickness of cIMT was higher in NS children as compared to control group in all the ages, but this difference was statistically significant only after 4 years of age. There was statistically significant, but weak positive correlation between cIMT and age of NS children, duration of disease and number of relapses. There was no correlation of cIMT with hypertension, body mass index, serum creatinine, and dyslipidemia. A negative, but statistically insignificant correlation of cIMT was found with serum albumin and serum cholesterol.

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

“…We had not found any correlation of CIMT with blood pressure, and this could be because only 12.2% of our NS children were hypertensive. Similar to our results, Mehta et al 21 reported no significant correlation between CIMT and blood pressure. Moreover, there were no significant correlations between CIMT and lipid profile in our patients.…”

“…Similar results were documented in the study by Hooman et al 20 who declared that common carotid artery CIMT in the patients group (0.42 ±.14) was higher than that of the control group (0.37 ±.08, p<0.05). Correspondingly, Mehta et al 21 in their study conducted on 66 children with NS and 128 age and sex matched healthy controls, found that CIMT was significantly higher in NS especially in the age above 4 years. However, unlike our results, Kniazewska et al 9 found no significant differences in CIMT between 30 children previously treated for nephrotic syndrome versus 30 healthy children.…”

Hyperlipidemia due to Nephrotic Syndrome: Its Effects and Effects of Interventions on Atherogenesis, Cardiovascular and Renal Outcomes

“…Ordonez et al, 1993 [9] The Thickness of carotid intima-media thickness (cIMT) was higher in NS children as compared to control group in all the ages, but this difference was statistically significant only after 4 years of age [5]. There was statistically significant positive correlation between cIMT and age, duration of disease and number of relapses.…”

“…In general, dyslipidemia accelerates atherosclerosis, and increases risk of myocardial infarction (MI) and cerebrovascular accident. Collected literatures on NS and the makers for atherosclerosis and cardiovascular events were shown in Table 1 [5,6,[9][10][11][12][13][14].…”

“…Mehta et al, 2019 [5] A case control study conducted at a tertiary care hospital Sixty-six children with NS who were more than 2 years with normal serum complement, being on therapy for NS for at least 1 year, GFR more than 90 mL/min/1.73 m 2 and absence of acute infection in previous 3 months and 128 age and sex matched children.…”