Augmentation index, a predictor of cardiovascular events, is increased in children and adolescents with primary nephrotic syndrome.
BACKGROUND
Arterial stiffness is associated with an increased risk of cardiovascular diseases. Augmentation index (AIx@75), a measure of arterial stiffness and wave reflection, has not been evaluated in patients with primary nephrotic syndrome (PNS). We investigated whether central and peripheral vascular profiles, hemodynamic parameters, and biochemical tests are associated with AIx@75 in PNS patients.


METHODS
This observational study involved 38 children and adolescents with PNS (12.14 ± 3.65 years) and 37 healthy controls (13.28 ± 2.80 years). Arterial stiffness and vascular and hemodynamic parameters were measured noninvasively using the Mobil-O-Graph® (IEM, Stolberg, Germany). In the PNS group, biochemical tests and corticosteroid dosage/treatment time were analyzed.


RESULTS
Peripheral and central systolic blood pressure (SBPp, SBPc) Z-scores were significantly higher in the PNS patients. AIx@75 was significantly higher in the PNS patients (25.14 ± 9.93%) than in controls (20.84 ± 7.18%). In the control group, AIx@75 negatively correlated with weight (r = - 0.369; p = 0.025), height (r = - 0.370; p = 0.024), and systolic volume/body surface (r = - 0.448; p = 0.006). In the PNS group, a univariate linear correlation showed that AIx@75 negatively correlated with weight (r = - 0.360; p = 0.027), height (r = 0.381; p = 0.18), and systolic volume/body surface (r = - 0.447; p < 0.002) and positively with the Z-score of SBPp (r = 0.407; p = 0.011), peripheral diastolic blood pressure (DBPp, r = 0.452; p = 0.004), SBPc (r = 0.416; p = 0.009), DBPc (r = 0.407; p = 0.011), triglycerides (r = 0.525; p = 0.001), and cholesterol [total (r = 0.539; p < 0.001), LDLc (r = 0.420; p = 0.010), and non-HDLc (r = 0.511; p = 0.001)].


CONCLUSIONS
Early abnormalities of AIx@75 and vascular parameters suggest that patients with PNS, even in stable condition, present subclinical indicators for the development of cardiovascular disease.
['Alves|Cláudia|C|', 'Pinho|José Felippe|JF|', 'Dos Santos|Luzia Maria|LM|', 'Magalhães|Giselle|G|', 'da Silva|Júnia Maria|JM|', 'Fontes|Fernanda Luiza|FL|', 'Caligiorne|Sordaini Maria|SM|', 'Pinheiro|Sérgio|S|', 'Rodrigues-Machado|Maria Glória|MG|']
D000293:Adolescent D001794:Blood Pressure D002318:Cardiovascular Diseases D002648:Child D003430:Cross-Sectional Studies D004305:Dose-Response Relationship, Drug D005260:Female D005938:Glucocorticoids D006339:Heart Rate D006801:Humans D008297:Male D009404:Nephrotic Syndrome D063177:Pulse Wave Analysis D018570:Risk Assessment D012307:Risk Factors D059289:Vascular Stiffness
Children Arterial stiffness Cardiovascular diseases Chronic kidney disease Dyslipidemia