Serum Endocan Levels Associated with Hypertension and Loss of Renal Function in Pediatric Patients after Two Years from Renal Transplant

Abstract

Endocan is an important biomarker of inflammation and endothelial dysfunction that increases in association with several chronic diseases. Few published data have described the role of endocan in pediatric renal transplant (RT) patients. We evaluated the endocan concentrations in 62 children who underwent renal transplantation and assessed their relationships with the patients' blood pressure and loss of renal function. The endocan levels were significantly elevated in the pediatric RT patients who had hypertension and a loss of renal function. We determined positive correlations between the endocan concentrations and the hemodynamic variables (systolic blood pressure: r = 0.416; P = 0.001; pulse pressure: r = 0.412; P = 0.003). The endocan levels were inversely correlated with the estimated glomerular filtration rate (r = −0.388; P = 0.003). An endocan cutoff concentration of 7.0 ng/mL identified pediatric RT patients who had hypertension and a loss of renal function with 100% sensitivity and 75% specificity. In conclusion, the endocan concentrations were significantly elevated in pediatric RT patients who had both hypertension and a loss of renal function. The correlations between the endocan levels and the hemodynamic variables and the markers of renal function strengthen the hypothesis that it is an important marker of cardiorenal risk.

Endothelial dysfunction as a factor leading to arterial hypertension

“…In adolescents with excess weight positive correlations between syndecan-1 and serum creatinine and triglycerides were found [56] The endocan levels were significantly elevated in the pediatric kidney transplant patients who had hypertension and a loss of kidney function [57] Endocan was increased almost threefold in children with metabolic syndrome compared to healthy controls [58] In children undergoing cardiac surgery on cardiopulmonary bypass, increases of circulating hyaluronan and syndecan-1 were present [59] Children with Kawasaki disease, especially with coronary involvement, had higher levels of syndecan-1 in plasma compared healthy controls [60] In children with type 1 diabetes an inverse correlation between serum glucose levels and glycocalyx thickness was observed [61]…”

Gait speed and handgrip strength as predictors of all-cause mortality and cardiovascular events in hemodialysis patient

“…Plasma endocan is known to exclusively originate from the vascular endothelium, and its levels reflect endothelial activation and systemic inflammation. Several previous studies have demonstrated the clinical values of plasma endocan in the prediction of cardiovascular mortality as well as the progression of kidney diseases [41][42][43][44]. It should be confirmed whether elevated levels of plasma endocan resulted from sarcopenia itself or from other confounding factors, such as vascular injuries or infection [45,46].…”

Gait speed and handgrip strength as predictors of all-cause mortality and cardiovascular events in hemodialysis patient

“…Plasma endocan is known to exclusively originate from the vascular endothelium, and its levels reflect endothelial activation and systemic inflammation. Several previous studies have demonstrated the clinical value of plasma endocan in the prediction of cardiovascular mortality as well as the progression of kidney diseases [48][49][50][51]. It should be confirmed whether elevated levels of plasma endocan result from sarcopenia itself or from other confounding factors, such as vascular injuries or infection [52,53].…”