title: Hyperlipidemia, oxidative stress, and intima media thickness in children with chronic kidney disease.
abstract: BACKGROUND
  The roles of dyslipidemia and oxidative stress in the early phases of atherosclerosis were tested in children with chronic kidney disease (CKD). Intima media thickness of common carotid arteries (cIMT) is used as a measure of early atherosclerosis.
  
  
  METHODS
  Fifty-two pediatric CKD patients were enrolled in the study (10 with chronic renal failure [CRF], 22 with a renal transplant [RT], 20 with chronic hemodialysis (cHD) patients, and 36 healthy children (control group, CG). Lipid status, oxidative stress, and paraoxonase 1 (PON1) status were assessed. cIMT was measured by ultrasound, adjusted for age and sex, and presented as standard deviation scores (SDS).
  
  
  RESULTS
  Children with CKD had disturbed lipid content, which was most pronounced in cHD children, with higher free cholesterol and triglycerides compared with healthy children. Oxidative stress was markedly increased (malodialdehyde [MDA, μmol/L]: CRF 1.50 ± 0.26, RT 1.55 ± 0.40, cHD 1.77 ± 0.34, CG 0.97 ± 0.33, p < 0.001) and antioxidative defense was compromised (superoxide dismutase [SOD, U/L]: CG 120 ± 21, CRF 84 ± 25, RT 93 ± 12, cHD 119 ± 37, p < 0.001). Multiple linear regression analysis showed that a model that included disease duration, blood pressure, urea, lipid, and oxidative status parameters accounted for more than 90% of the variability of cIMT-SDS.
  
  
  CONCLUSIONS
  Early atherosclerosis in CKD children is caused, at least in part, by dyslipidemia and oxidative stress. Monitoring of vessel wall changes, along with assessment of oxidative stress status and high density lipoprotein (HDL) functionality is necessary to ensure better therapeutic strategies for delaying atherosclerotic changes in their asymptomatic phase.
authors.affiliation: Department for Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, P. Box 146, 11000 Belgrade, Serbia. jkotur@pharmacy.bg.ac.rs
authors.forename: Jelena
authors.initials: J
authors.lastname: Kotur-Stevuljević
authors.forename: Amira
authors.initials: A
authors.lastname: Peco-Antić
authors.forename: Slavica
authors.initials: S
authors.lastname: Spasić
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Stefanović
authors.forename: Dušan
authors.initials: D
authors.lastname: Paripović
authors.forename: Mirjana
authors.initials: M
authors.lastname: Kostić
authors.forename: Dragan
authors.initials: D
authors.lastname: Vasić
authors.forename: Ana
authors.initials: A
authors.lastname: Vujović
authors.forename: Zorana
authors.initials: Z
authors.lastname: Jelić-Ivanović
authors.forename: Vesna
authors.initials: V
authors.lastname: Spasojević-Kalimanovska
authors.forename: Danijela
authors.initials: D
authors.lastname: Kornic-Ristovski
mesh_terms: D000293:Adolescent; D000328:Adult; D062107:Advanced Oxidation Protein Products / Q000097:blood; D000704:Analysis of Variance; D043303:Aryldialkylphosphatase / Q000097:blood; D050197:Atherosclerosis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D002648:Child; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000209:etiology*; D016030:Kidney Transplantation; D016014:Linear Models; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D018384:Oxidative Stress; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications* / Q000628:therapy*; D013482:Superoxide Dismutase / Q000097:blood; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D062107:Advanced Oxidation Protein Products; D014280:Triglycerides; D008315:Malondialdehyde; D002784:Cholesterol; D013482:Superoxide Dismutase; D043303:Aryldialkylphosphatase