Association of clearance of middle- and large-molecular-weight substance with arterial stiffness and left ventricular mass in children receiving renal replacement therapy.
BACKGROUND
The prominent cause of mortality in children receiving dialysis treatment is cardiovascular diseases. Risk factors related to chronic renal disease, are effective in the development of cardiovascular diseases. The aim of study was to investigate cardiovascular system (CVS) involvement for functional and structural alterations in children receiving dialysis, and display any association between cardiovascular morbidity and uremic toxins.


METHODS
20 dialysis patients and 20 healthy controls were included to the study. Clearance of small, middle and large molecular-weight uremic toxins was evaluated in blood samples collected 30 minutes before (D0) and 2 hour after dialysis (D2), and change value was calculated as D0-D2/D0. Cardiovascular involvement was determined by comparing arterial stiffness, carotid intima-media thickness (CIMT) and Left Ventricular Mass Index (LVMI) with the control group.


RESULTS
Four patients receiving hemodialysis and two patients in continuous ambulatory peritoneal dialysis (CAPD) group who have significant differences in all functional and structural parameters were detected. Four dialysis patients with detected cardiovascular disease have distinctively lower beta-2 microglobulin and homocysteine clearances compared to the patients with no CVS involvement.


CONCLUSIONS
The clearance of middle and large molecular-weight substances should be closely monitored in children receiving dialysis.
Department of Pediatric Nephrology, Ege University School of Medicine, İzmir, Turkey - kcanturk1@hotmail.com.
Kadriye
K
Özdemir
Department of Pediatric Nephrology, Ege University School of Medicine, İzmir, Turkey.
Ebru
E
Yilmaz
Department of Pediatric Nephrology, Ege University School of Medicine, İzmir, Turkey.
Nida
N
Dincel
Department of Pediatric Cardiology, Ege University School of Medicine, İzmir, Turkey.
Sibel
S
Bozabali
Department of Pediatric Nephrology, Ege University School of Medicine, İzmir, Turkey.
Sukriye
S
Apaydin
Department of Pediatric Nephrology, Ege University School of Medicine, İzmir, Turkey.
Zubeyr H
ZH
Gun
Department of Pediatric Nephrology, Ege University School of Medicine, İzmir, Turkey.
Betul
B
Sozeri
Department of Pediatric Nephrology, Ege University School of Medicine, İzmir, Turkey.
Sevgi
S
Mir
D000293:Adolescent; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006352:Heart Ventricles / Q000378:metabolism; D006710:Homocysteine / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008970:Molecular Weight; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000379:methods*; D006435:Renal Dialysis / Q000379:methods*; D012307:Risk Factors; D013997:Time Factors; D014118:Toxins, Biological / Q000378:metabolism; D059289:Vascular Stiffness / Q000502:physiology; D001613:beta 2-Microglobulin / Q000378:metabolism
D014118:Toxins, Biological; D001613:beta 2-Microglobulin; C026865:uremia middle molecule toxins; D006710:Homocysteine