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Minerva Pediatrica 2017 December;69(6):495-502

DOI: 10.23736/S0026-4946.16.04253-5


lingua: Inglese

Association of clearance of middle- and large-molecular-weight substance with arterial stiffness and left ventricular mass in children receiving renal replacement therapy

Kadriye ÖZDEMIR 1 , Ebru YILMAZ 1, Nida DINCEL 1, Sibel BOZABALI 2, Sukriye APAYDIN 1, Zubeyr H. GUN 1, Betul SOZERI 1, Sevgi MIR 1

1 Department of Pediatric Nephrology, Ege University School of Medicine, İzmir, Turkey; 2 Department of Pediatric Cardiology, Ege University School of Medicine, İzmir, Turkey


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.

KEY WORDS: Uremia middle molecule toxins - Cardiovascular system - Renal dialysis

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