Abstract
Background: Chronic kidney disease (CKD) is associated with cardiovascular morbidity and mortality. Osteopontin (OPN) is a critical factor in developing atherosclerosis and increases the risk for a major adverse cardiovascular event. Aim: To investigate osteopontin serum levels in hemodialysis children and detect the association between the main arteries’ intimal medial thickness (IMT) and peak systolic velocity. Material and Methods: This case-control study included 30 children on regular hemodialysis and 30 children age and sex-matched as controls their age range from 4 to 18 years; we investigated osteopontin serum level in addition to the Doppler ultrasound assessment of intimal medial thickness and peak systolic velocity (PSV) of the main arteries in the same line with the traditional markers of the routine investigations of children on regular hemodialysis. Results: Significantly high osteopontin level in hemodialysis children than the controls was (0.85 ± 0.21 ng/ml) (0.69 ± 0.26 ng/ml), respectively (p = 0.026). A significant increase in the (IMT) of the main arteries, including the carotid and femoral arteries, in the patient’s group than the controls, was (0.51 ± 0.01 mm) (0. 69. ± 0.01 mm) (0.32 ± 0.036 mm) (0.55 ± 0.01), respectively (p = 0.001). There is a strong correlation between (OPN) with the (IMT) of carotid and femoral arteries, a significant positive correlation between (OPN) with urea, creatinine, triglyceride, PTH, ferritin, CRP, and ESR, and a negative correlation with RBCs count and carotid PSV. Conclusion: High osteopontin level is consistent with the increased IMT of the main arteries in hemodialysis children that seem to play a significant role in developing and propagating atherosclerosis in hemodialysis children, evidenced by significant association with inflammatory markers and uremic toxins.
Highlights
Chronic kidney disease (CKD) is associated with a substantially increased risk of cardiovascular morbidity and mortality, independent of traditional cardiovascular risk factors, such as diabetes and hypertension (Kakitapalli et al, 2020) [1].The risk of cardiovascular events is increased markedly in patients with severe CKD, with cardiovascular mortality being 10 - 30-fold higher than that of agematched controls
Material and Methods: This case-control study included 30 children on regular hemodialysis and 30 children age and sex-matched as controls their age range from 4 to 18 years; we investigated osteopontin serum level in addition to the Doppler ultrasound assessment of intimal medial thickness and peak systolic velocity (PSV) of the main arteries in the same line with the traditional markers of the routine investigations of children on regular hemodialysis
High osteopontin level is consistent with the increased intimal medial thickness (IMT) of the main arteries in hemodialysis children that seem to play a significant role in developing and propagating atherosclerosis in hemodialysis children, evidenced by significant association with inflammatory markers and uremic toxins
Summary
CKD is associated with a substantially increased risk of cardiovascular morbidity and mortality, independent of traditional cardiovascular risk factors, such as diabetes and hypertension (Kakitapalli et al, 2020) [1].The risk of cardiovascular events is increased markedly in patients with severe CKD, with cardiovascular mortality being 10 - 30-fold higher than that of agematched controls. Traditional risk factors of CVD such as hypertension and dyslipidemia cannot fully explain the increased rate of cardiovascular events reported in patients with CKD. Osteopontin (OPN) is a bone-specific sialoprotein with three splice variants with several post-translational modifications, acute and chronic inflammatory cells, smooth muscle, epithelial and endothelial cells, neurons, and several posttranslational modifications fetal renal tissue. Aim: To investigate osteopontin serum levels in hemodialysis children and detect the association between the main arteries’ intimal medial thickness (IMT) and peak systolic velocity. Conclusion: High osteopontin level is consistent with the increased IMT of the main arteries in hemodialysis children that seem to play a significant role in developing and propagating atherosclerosis in hemodialysis children, evidenced by significant association with inflammatory markers and uremic toxins
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