Carotid intima media thickness, oxidative stress, and inflammation in children with chronic kidney disease.
OBJECTIVE
We evaluated the association between inflammation and oxidative stress with carotid intima media thickness (cIMT) and elasticity increment module (E(inc)) in pediatric patients with chronic kidney disease (CKD).


METHODS
This analytical, cross-sectional study assessed 134 children aged 6-17 years with CKD. Anthropometric measurements and biochemistry of intact parathyroid hormone (iPTH), high-sensitivity C-reactive protein (CRP), interleukin (IL)-6, IL-1β, reduced glutathione (GSH), malondialdehyde, nitric oxide, and homocysteine were recorded. Bilateral carotid ultrasound (US) was taken. Patients were compared with controls for cIMT and E(inc) using ≥ 75 percentile (PC).


RESULTS
Mean cIMT was 0.528 ± 0.089 mm; E(inc) was 0.174 ± 0.121 kPa × 10(3); cIMT negatively correlated with phosphorus (r -0.19, p =0.028) and the calcium × phosphorus (Ca × P) product (r -0.26, p =0.002), and positively with iPTH (r 0.19,p =0.024). After adjusting for potential confounders, hemodialysis (HD) (β=0.111, p =<0.001), automated peritoneal dialysis (APD) (β=0.064, p =0.026), and Ca x P product(β=-0.002, p =0.015) predicted cIMT (R(2)=0.296). In patients on dialysis, HD (β=0.068, p =0.010), low-density lipoprotein cholesterol (LDL-C) (β=0.001, p =0.048), and GSH(β=-0.0001, p=0.041) independently predicted cIMT (R(2)=0.204); HD, hypoalbuminemia, and high iPTH increased the risk of increased cIMT. In dialysis, E(inc) was inversely associated with GSH, and in predialysis, Ca × P correlated with/predicted E(inc) (β=0.001, p =0.009).


CONCLUSIONS
cIMT and E(inc) strongly associate with several biochemical parameters and GSH but not with other oxidative stress or inflammation markers.
Juan Antonio
JA
Garcia-Bello
Rita A
RA
Gómez-Díaz
Alicia
A
Contreras-Rodríguez
Juan O
JO
Talavera
Rafael
R
Mondragón-González
Lorena
L
Sanchez-Barbosa
Margarita
M
Diaz-Flores
Adan
A
Valladares-Salgado
Juan Manuel
JM
Gallardo
Alejandra
A
Aguilar-Kitsu
Jesus
J
Lagunas-Munoz
Niels H
NH
Wacher
D000293:Adolescent; D015415:Biomarkers / Q000032:analysis; D059168:Carotid Intima-Media Thickness; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D055119:Elastic Modulus; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications*; D008297:Male; D018384:Oxidative Stress / Q000502:physiology*; D051436:Renal Insufficiency, Chronic / Q000150:complications*
D015415:Biomarkers