Endothelial dysfunction and elemental status in children with chronic kidney disease

• Main Authors: T. P. Makarova, Yu. S. Melnikova
• Format: Article
• Language: Russian
• Published: Ltd. “The National Academy of Pediatric Science and Innovation” 2018-04-01
• Series: Rossijskij Vestnik Perinatologii i Pediatrii
• Subjects: children; chronic kidney disease; endothelial dysfunction; blood pressure; zinc; iron; magnesium
• Online Access: https://www.ped-perinatology.ru/jour/article/view/644

Objective: evaluation of markers of endothelial dysfunction (endothelin-1 and nitric oxide) and elemental status (zinc, iron, magnesium) in children and adolescents at different stages of chronic kidney disease (CKD). The study includes 104 patients aged 2 to 17 years with different stages of CKD: 63 patients with I stage of CKD, and 26 patients with CKD stage III and 15 patients with CKD V stage. Results: in patients with CKD, endothelin-1 increased with simultaneous decrease in production of nitric oxide in the progression of CKD from I to V stage. The increase of the content of endothelin-1 by 2.5 times determined in patients with stage V CKD, which was accompanied by a decline of the ratio of the concentrations of NO/ET-1 by 5.5 times. In patients with CKD, elemental status impairments were detected, manifested by a decrease in the content of zinc, iron, and magnesium in the serum of blood at the first stage, with the maximum implementation in stage III CKD. Hypertension was detected in 68.3% of patients with CKD. Direct correlations were found between the content of serum iron and magnesium with the level of arterial pressure in patients with stage I CKD. In III and V stage CKD, a direct correlation of serum magnesium with blood pressure level and nitric oxide concentration was established. Conclusion: children with CKD have endothelial dysfunction and elemental status disorders, beginning with the first stage of CKD development, which can be considered as factors determining the progression of the pathological process in the kidneys.