Endothelin 1 and endothelial dysfunction in children with idiopathic nephrotic syndrome

Abstract

Background: Endothelial dysfunction is the initial step for atherogenesis. Children with idiopathic nephrotic syndrome are at risk of endothelial dysfunction due to altered cholesterol metabolism which can lead to early atherosclerosis. Methods: In this analytical study with longitudinal follow up 25 children with first episode of nephrotic syndrome (FENS) aged 1–16 years along with 25 age and gender matched healthy controls were enrolled. Endothelin 1 (ET 1) levels were measured by ELISA (Cloud Clone Corp. and assembled by USCN Inc, U.S.A). Other variables were measured using standard biochemical methods. Primary outcome measure was plasma ET 1 level in children with FENS and in controls. Secondary outcome measure was to observe the levels of ET 1 in children with FENS at 12 weeks in remission. Results: The level of ET 1 was significantly higher (p < 0.001) in children with FENS as compared to controls. The level of ET 1 was significantly higher (p = 0.006) in SSNS at the onset of nephrotic syndrome and was significantly lower (p = 0.04) after 12 weeks of drug induced remission as compared to controls. SRNS children had higher levels of ET 1 than the steroid sensitive patients at onset but in was not statistically significant (p = 0.062). ET 1 showed significant positive correlation with total cholesterol (r = 0.462; p = 0.001) and negative correlation with serum albumin (r = −0.565; p = 0.001). Conclusion: Plasma ET 1 levels are raised in children with FENS posing a risk of endothelial dysfunction, which persists at least in short term. Long term effects of raised plasma ET 1 needs to be studied.

Keywords

• Endothelin 1
• Nephrotic syndrome
• Endothelial dysfunction
• Children