Assessment of Indices of Vascular Involvement in Children with Idiopathic Nephrotic Syndrome: A Case-control Study

Abstract

Introduction: Nephrotic Syndrome (NS) is characterised by proteinuria, oedema, hypoalbuminaemia, and hypercholesterolemia. The latter is a risk factor for atherosclerosis, suggesting a higher risk of cardiovascular disease in children with NS. Atherosclerosis is proposed to be caused by vascular endothelial dysfunction, reflecting the inflammatory response to tissue damage. Aim: To investigate indices of early vascular involvement in children with Idiopathic Nephrotic Syndrome (INS). Materials and Methods: This case-control study was conducted at a tertiary-care hospital, Pt. BD Sharma PGIMS Rohtak, Haryana, India, over a period of two years and two months. The study included 50 children aged <14 years with NS. Vascular indices, including Carotid Intima Media Thickness (CIMT), highsensitive C Reactive Protein (hs-CRP), and Atherogenic Index of Plasma (AIP), were evaluated. Analysis was performed using Statistical Package for the Social Sciences (SPSS) version 22.0 (IBM SPSS Statistics Inc., Chicago, Illinois, USA) Windows software program. The correlation of cardiovascular risk in children with NS was calculated by measuring CIMT, AIP, and CRP levels, and the relationship was analysed using the Chisquare test. A p-value of <0.05 was considered statistically significant. Results: The study found that the thickness of CIMT in group 1 was 0.67±1.39 mm, while in group 2, it was 0.31±0.04 mm. The calculated p-value was <0.001, which was statistically significant. The hs-CRP level in group 1 was 4.64±5.87 mg/L, higher than the control group (0.85±0.10 mg/L), with p-value of <0.001. Furthermore, AIP was higher in children with NS (0.80±0.19) compared to the control group (0.02±0.16). There was a statistically significant difference between both groups (p<0.001). Conclusion: Early assessment of indices of vascular involvement, such as CIMT, hs-CRP, and AIP, in children with INS can aid in the early identification and prevention of cardiovascular complications.