title: Brachial artery flow-mediated dilatation and carotid intima medial thickness in pediatric nephrotic syndrome: a cross-sectional case-control study.
abstract: BACKGROUND
  Children with nephrotic syndrome (NS) have hyperlipidemia, which may lead to endothelial dysfunction. This study evaluated endothelial function and structural atherosclerosis in NS children with disease duration more than 2 years, by assessment of brachial artery flow-mediated dilatation (FMD) and carotid intima medial thickness (CIMT).
  
  
  METHODS
  This is a cross-sectional case-control study recruiting 32 subjects aged 1-13 years with NS and 32 matched controls. Clinical details, FMD and CIMT were recorded. Lipid profile and oxidative stress were also analyzed in the subjects.
  
  
  RESULTS
  The proportionate change in FMD was significantly lower in cases (5.65 ± 6.08 %) compared to controls (15.21 ± 9.41 %) (p < 0.01). No significant differences in CIMT were observed (p = 0.383). Blood malondialdehyde was significantly higher (p = 0.006) in the cases. Overall, 25 NS children (78 %) were in remission for more than 6 months, and in them, 9 (36 %) had deranged lipid profile. On stepwise linear regression, age of the patient was found to be a determinant of FMD (model R (2) = 18.9 %, p value = 0.048).
  
  
  CONCLUSIONS
  The significantly low proportionate change in FMD in NS children suggests an ongoing process of endothelial dysfunction. Further studies are needed to confirm these findings. A long-term follow-up of children with NS may be required for identification of CIMT derangements.
authors.affiliation: Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, 605006, India.
authors.forename: Illaparambath
authors.initials: I
authors.lastname: Rahul
authors.forename: Sriram
authors.initials: S
authors.lastname: Krishnamurthy
authors.forename: Santhosh
authors.initials: S
authors.lastname: Satheesh
authors.forename: Niranjan
authors.initials: N
authors.lastname: Biswal
authors.forename: Zachariah
authors.initials: Z
authors.lastname: Bobby
authors.forename: Subitha
authors.initials: S
authors.lastname: Lakshminarayanan
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D001916:Brachial Artery / Q000502:physiology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D050356:Lipid Metabolism; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D009404:Nephrotic Syndrome / Q000473:pathology* / Q000503:physiopathology*; D018384:Oxidative Stress; D014664:Vasodilation / Q000502:physiology*
chemical_list: D008315:Malondialdehyde