Pediatrics World Conference 2026

Abstract

BACKGROUND
Nephrotic syndrome is the most common glomerulopathy of  childhood. A child with NS gets exposed to the following  risk factors that are atherogenic including hyperlipidemia , frequent infections, sustained proteinuria. All these factors contributes to endothelial dysfunction and structural atherosclerosis. Flow mediated dilatation of brachial artery and Carotid artery intima media thickness are the non invasive tests used in assessing the endothelial dysfunction.

AIMS & OBJECTIVES.

To evaluate the endothelial dysfunction and structural atherosclerosis in children with nephrotic syndrome by Brachial artery flow mediated  dilatation   and carotid intima media thickness respectively. To assess the predictors of Endothelial dysfunction

MATERIALS AND METHODS

From May 2021 to May 2022, this prospective cross sectional case control study was conducted in Institute of Child Health and Hospital for Children, Chennai. The study involved 60 cases of nephrotic syndrome and 60 controls. Demographic details, basic investigations and specific investigations for endothelial dysfunction including Flow mediated dilatation of brachial artery and Carotid intima media thickness were assessed in the patients who met the inclusion criteria and the controls. 

RESULTS
The present study has demonstrated significant endothelial dysfunction as evident by the reduced flow mediated dilatation of the brachial artery and increasing carotid intima media thickness in nephrotic syndrome patients between 1 to 12 yrs of age irrespective of the type of nephrotic syndrome and severity of  illness. 
The predictive risk factors identified to cause endothelial dysfunction were hypertension ,  elevated BMI , hyperlipidemia , hypoalbuminemia and increasing duration of illness.  

CONCLUSION

The endothelial dysfunction is  evident in any case of nephrotic syndrome. Early identification of the same by serial follow up of the patient even after the remission state would greatly help in reducing the cardiovascular morbidity and related mortalities. We also recommend that routine and earlier initiation of statins in patients with hyperlipidemia and its consideration for other mentioned risk factors might contribute to prevention of cardiovascular morbidity