title: Dyslipidemia, carotid intima-media thickness and endothelial dysfunction in children with chronic kidney disease.
abstract: Chronic kidney disease (CKD) predisposes to accelerated atherosclerosis that is measured by carotid artery intima-media thickness (cIMT) and brachial artery flow-mediated dilation (FMD). Information on the association of these parameters with dyslipidemia in pre-dialysis pediatric CKD is limited.
  
  
  
  Eighty patients aged 9.9 ± 3.2 years, with estimated glomerular filtration rate of 38.8 ± 10.8 ml/1.73 m(2)/min, and 42 pediatric controls underwent cross-sectional analysis of lipid profile, cIMT, and brachial artery FMD. Significant differences in these parameters between patients and controls were analyzed using Student's t test. Predictors of cIMT and dyslipidemia were assessed using linear and logistic regression respectively.
  
  
  
  Patients had elevated blood levels of triglyceride and of total and LDL cholesterol than controls (P ≤ 0.001); 73.8 % were dyslipidemic. Mean cIMT was higher (0.421 ± 0.054 mm vs 0.388 ± 0.036 mm, P = 0.001) and brachial artery FMD was reduced (10.6 ± 4.9 % vs 18.9 ± 4.1 %, P < 0.0001) in patients compared with controls. On multivariate analysis, hypertension (OR 3.68, P = 0.044) and male gender (OR 10.21, P = 0.004) were associated with dyslipidemia; cIMT was significantly associated with LDL cholesterol (β = 28.36, P = 0.033).
  
  
  
  Dyslipidemia was prevalent and cIMT significantly elevated in pre-dialysis pediatric CKD, indicating increased cardiovascular risk. Elevated LDL cholesterol predicted increased cIMT, strengthening the association between dyslipidemia and atherosclerosis in early CKD.
authors.affiliation: Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Khandelwal
authors.affiliation: Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Vijaya
authors.initials: V
authors.lastname: Murugan
authors.affiliation: Department of Radiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Smriti
authors.initials: S
authors.lastname: Hari
authors.affiliation: Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Ramakrishnan
authors.initials: R
authors.lastname: Lakshmy
authors.affiliation: Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Aditi
authors.initials: A
authors.lastname: Sinha
authors.affiliation: Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. pankajhari@hotmail.com.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Hari
authors.affiliation: Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Arvind
authors.initials: A
authors.lastname: Bagga
mesh_terms: D059168:Carotid Intima-Media Thickness; D002648:Child; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000453:epidemiology*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D014652:Vascular Diseases / Q000453:epidemiology* / Q000209:etiology; D014664:Vasodilation
keywords: Atherosclerosis; Chronic renal insufficiency; Hypertension; Low-density lipoprotein cholesterol; Triglyceride