Pulse Wave Analysis in Children with Glomerulopathies
Maria Roszkowska-Blaim*, Piotr Skrzypczyk and Zofia Wawer
Department of Pediatrics and Nephrology, Medical University of Warsaw, Poland
- *Corresponding Author:
- Maria Roszkowska-Blaim
Department of Pediatrics and Nephrology
Medical University of Warsaw
24 Marszalkowska St 00-576 Warsaw, Poland
Tel: +48 22 621 98 63
Fax: +48 22 621 98 63
E-mail: [email protected]
Received Date: June 02, 2013; Accepted Date: August 15, 2013; Published Date: August 20, 2013
Citation: Blaim MR, Skrzypczyk P, Wawer Z (2013) Pulse Wave Analysis in Children with Glomerulopathies. J Nephrol Ther 3:134. doi:10.4172/2161-0959.1000134
Copyright: © 2013 Blaim MR, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Sympathetic activation, hypertension, hyperlipidemia, and immunosuppressive treatment are risk factors for vascular damage in children with glomerulopathies.
Aim: To perform pulse wave analysis in children with glomerulopathies.
Material and Methods: We studied 33 children (22Ã¢Â™Â‚, 11Ã¢Â™Â€) aged 13.3 ± 3.9 years with glomerulopathies: Henoch-Schonlein nephropathy 9 patients, IgA nephropathy 7 patients, membranoproliferative glomerulonephritis 4 patients, mesangioproliferative glomerulonephritis 3 patients, minimal change disease 3 patients, focal segmental glomerulosclerosis (FSGS) 3 patients, and other nephropathies 4 patients. We evaluated age at the disease onset, development of hypertension, body mass index (BMI) Z-score, selected biochemical variables, glomerular filtration rate (ac. to Schwartz formula), and pulse wave parameters determined using a SphygmoCor device (AtCor Medical, Australia): aortic systolic pressure (AoSP), diastolic pressure (AoDP) and pulse pressure (AoPP), augmentation pressure (AP), augmentation index (AIx), augmentation index corrected for heart rate of 75 beats per minute (AIx-75HR) [%], and an index of myocardial oxygen supply and demand, subendocardial viability ratio (SEVR) [%]. The control group included 20 healthy children matched for age and gender.
Results: Children with glomerulopathies showed trends for higher mean AP (P=0.08) and AIx (P=0.07), and a significantly higher mean AIx-75HR (P<0.05). Patients with hypertension (n=13) showed higher mean AoDP (P<0.05) and AIx-75HR (P<0.05) compared to normotensives (n=20). Six (18.2%) overhydrated patients had significantly (P<0.05) higher diastolic peripheral and aoritc diastolic blood pressure, as well as aortic systolic blood pressure than 27 (81.8%) normovolemic children. In 33 children, AoSP and AoDP correlated positively with proteinuria (r=0.44, P<0.05; and r=0.57, P<0.05, respectively); AoDP showed negative correlations with albumin (r=-0.42, P<0.05), total protein (r=- 0.36, P<0.05), calcium level (r=-0.47, P<0.05). AoPP correlated positively with BMI Z-score (r=0.43, P<0.05), and SEVR negatively with total cholesterol level (r=-0.43, P<0.05).
Conclusions: i. Patients with glomerulopathies show increased arterial stiffness compared to their healthy peers. ii. In children with glomerulonephritis, hypertension is a risk factor for increased aortic stiffness, and hypercholesterolemia may be a risk factor for future myocardial ischemia. iii. Overhydration in children with glomerulonephritis can increase peripheral and central blood pressure without influencing arterial stiffness.