Evaluation of endothelial progenitor cell (CD34) as a marker of cardiovascular risk in children on regular hemodialysis

Abstract

Endothelial progenitor cells (EPCs) CD34 are bone marrow-derived cells that decrease in chronic kidney disease (CKD) patients especially when they reach end-stage renal disease and may be a risk marker of cardiovascular (CV) diseases. The aim of our study is to investigate the endothelial progenitor cell CD 34 numbers in children with CKD on regular hemodialysis (HD) and detect their association with vascular stiffness. We recruited 25 children on regular HD, who were selected from the HD unit of Al-Zahraa Hospital, Al-Azhar University. Another group of 25 age and sex matched healthy children served as as controls. We investigated the number of EPC number (CD34) using flow cytometry, intima-media thickness (IMT), and the peak systolic velocity (PSV) of the main arteries including the (aorta, carotid, and femoral) arteries using Doppler ultrasound, this is in the same line with the routine and traditional investigations of the CV risk in the study groups. Children on regular HD have significantly lower EPC numbers (CD34 numbers) compared to their controls, the median and the inter equatorial range of CD34 was 57 (17–122) and five (3–6), respectively (P 0.001). Significant positive correlations were found between CD 34 and triglycerides serum level (r = 0.817, P = 0.001), also between CD34 with IMT and PSV of the aorta (r = 0.685, P = 0.000: r = 0.457, P = 0.022), respectively. CD34 is 88% sensitive and specific for the detection of CV risk in children on regular HD. EPC CD34 exhibited a higher predictive value for CV risk in children on regular HD. Reduced EPC numbers contribute to accelerated atherosclerosis.