Role of carotid-femoral (aortic) pulse wave velocity measurement in the evaluation of cardiovascular risk in children with idiopathic nephrotic syndrome

Abstract

Introduction and objective: The study was aimed to evaluate carotid-femoral (aortic) pulse wave velocity (cfPWV) in children with idiopathic nephrotic syndrome. Materials and methods: A total of 48 children with idiopathic nephrotic syndrome were enrolled in the study, including 35 patients in acute phase and 32 in remission. In 19 patients, measurements were performed twice: in relapse and in remission. The control group consisted of 22 healthy children. In all children, cfPWV measurements were performed. Selected clinical, biochemical parameters and fetuin-A concentrations were determined. Results: The patients with idiopathic nephrotic syndrome had significantly higher cfPWV both in relapse and in remission, as compared to the control group. Fetuin-A levels were significantly lower in both phases of the disease than in the healthy controls. cfPWV in relapse positively correlated with body weight, body mass index, systolic, diastolic, mean and pulse pressure. cfPWV in remission positively correlated with body weight, residual proteinuria, and total and low-density lipoproteins cholesterol. Systolic blood pressure in relapse, body weight, and total cholesterol in remission were found to be independent risk factors for increased cfPWV. Total cholesterol in remission was an independent risk factor for an increase of cfPWV to height rate. Conclusions: Increased cfPWV in children with idiopathic nephrotic syndrome indicates the possibility of premature cardiovascular complications. Significant effects of the modifiable risk factors, such as arterial pressure, body weight and disturbances of lipid metabolism, on arterial stiffness may contribute to early diagnostic and therapeutic interventions to improve the prognosis in patients with idiopathic nephrotic syndrome. Measurements of cfPWV may be useful in the assessment of cardiovascular risk in children with idiopathic nephrotic syndrome.