Title: Lipid metabolism disturbances in children with chronic renal failure treated conservatively
- Anita Chudzik, Cezary Watała, Barbara Strzałko-Głoskowska, Małgorzata Stefańska, Jarosław Wilkowski, Anna Puziewicz-Zmonarska, Danuta Zwolińska, Sławomir Cezary Zmonarski, Irena Makulska
- Original articles
- Pediatric Review
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- Final page:
- lipid metabolism, children, chronic renal failure, atheromatous indexes
Lipid metabolism disturbances, a permanent feature of chronic renal failure (CRF) in adults, contribute to increased risk of cardiovascular mortality. At present, there are very few studies on the effect of uraemia on the lipid profiles in children. The aim of the study was to estimate lipid metabolism parameters and to attempt the estimation of a risk of accelerated atherogenesis parameters in children with CRF conservatively treated.The study population consisted of fifty-seven children with CRF, aged 2 months-18,3 years. They were divided into three groups, depending on their serum creatinine levels. The control group comprised 24 healthy children, aged 2,0- 14,7 years.
All the patients were tested for serum lipid parameters: total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-CHOL), low-density lipoprotein cholesterol (LDL-CHOL), triglicerides (TG), apolipoproteins AI and B (ApoAI, ApoB). In every case atheromatous indexes: TC/HDL-CHOL, LDL-CHOL/HDL-CHOL, ApoAI/ApoB were calculated. The results show that TG serum concentration in CRF children was significantly higher than in healthy controls. TC/HDL-CHOL and LDL-CHOL/HDL-CHOL indexes values in moderate and advanced CRF were significantly higher than in controls. ApoAI/ApoB index values were lower in all the stages of CRF in comparison to controls, but the difference was significant only in moderate stage of the disesase. Conclusions: 1. Hipertrigliceridemia is a permanent feature of CRF in children, it is observed just in mild and moderate renal failure. Other lipid metabolism parameters fluctuate. Lipid profile disturbances, observed in advanced CRF, undergo partial normalization in comparison to children with moderate CRF. 2. The risk of acceleration of atherosclerosis and cardiovascular disease development in children with chronic renal failure increases considerably already in the moderate stage of the disease. This supports the idea of prophylaxis early in the course of CRF.