Endothelial Dysfunction in Children with Steroid-Resistant Nephrotic Syndrome

Background: Steroid-resistant nephrotic syndrome (SRNS) is associated with early atherosclerosis because of comorbidities including persistent hyperlipidemia and hypertension. The aim of this study was to determine the incidence of abnormal carotid intima-media thickening (cIMT) as an early sign of atherosclerosis in a small group of children with SRNS. Methods: A total of 8 children with SRNS (mean age, 10.8±4.2 years at recruitment and mean disease duration, 40.9± 20.7 months) were studied; all children were normotensive. B-mode ultrasound was used to measure cIMT, and the results were compared with healthy controls. Results: Children with SRNS had significantly thicker CIMT (0.44±0.04 mm), compared to the controls (0.37±0.59 mm) (P < 0.01). A high level of total cholesterol (5.4± 2.0 mmol/L; normal < 5.2 mmol/L) was reported in these children, while normal levels of lowdensity lipoprotein, very-low-density lipoprotein, triglyceride, and high-density lipoprotein were found. Also, the mean creatinine level was 45.1 ± 15.0 μmol/L, and the mean urea level was 4.2 ± 1.8 mmol/L. Conclusions: Children with SRNS had an abnormal vascular phenotype with a thicker CIMT, compared to the controls and showed evidence of hypercholesterolemia.