Fadel Fatina, Bazraa Hafez M, Abdelrahman Safaa M, Shouman Mohamed Gamal, Sayed Marwa Khaled, Salah Doaa Mohamed, Wahby Aliaa Ahmed, Elgebaly Heba F
Department of Pediatrics, Center of Pediatric Nephrology and Transplantation (CPNT), Cairo University, Cairo, Egypt.
EGORD, Egyptian Group of Orphan Renal Diseases, Cairo, Egypt.
Open Access Maced J Med Sci. 2017 Apr 13;5(2):222-227. doi: 10.3889/oamjms.2017.032. eCollection 2017 Apr 15.
Renal transplantation (RTx) is the treatment of choice for paediatric end-stage renal disease (ESRD). A major cause of morbidity and mortality after RTx is cardiovascular disease. Independent predictors of cardiovascular events were shown to constitute an endothelial dysfunction (ED). This study aims to evaluate Visfatin serum level in comparison to brachial artery flow-mediated dilatation (FMD) as a marker of endothelial dysfunction in paediatric RTx recipients.
Visfatin serum level has been evaluated in 30 patients on regular hemodialysis (HD), 36 patients post-RTx and 30 controls as a measure for ED, and has been compared to brachial artery FMD.
Visfatin level in transplant recipients was significantly lower than the hemodialysis group as well as FMD was better in transplant recipients. In spite of marked improvement of FMD and marked reduction of visfatin in post-RTx no direct statistical correlation was found between serum Visfatin level and flow-mediated dilatation.
Pediatric RTx recipients show lower serum Visfatin level and better FMD than those on regular hemodialysis, reflecting less endothelial dysfunction (ED) and less cardiovascular risk. FMD in kidney transplant recipients tends to be less than normal subjects while visfatin level of the same group is similar to controls. Pediatric RTx appears to have a positive impact on the growth development of children with ESRD.
肾移植（RTx）是小儿终末期肾病（ESRD）的首选治疗方法。RTx后发病和死亡的主要原因是心血管疾病。心血管事件的独立预测因素显示为内皮功能障碍（ED）。本研究旨在评估小儿RTx受者的内脂素血清水平，并与肱动脉血流介导的舒张功能（FMD）进行比较，以作为内皮功能障碍的标志物。
评估了30例接受定期血液透析（HD）的患者、36例RTx后的患者和30例对照者的内脂素血清水平，作为ED的一项指标，并与肱动脉FMD进行比较。
移植受者的内脂素水平显著低于血液透析组，且移植受者的FMD更好。尽管RTx后FMD有显著改善，内脂素显著降低，但血清内脂素水平与血流介导的舒张功能之间未发现直接的统计学相关性。
小儿RTx受者的血清内脂素水平低于接受定期血液透析的患者，FMD更好，这反映出其内皮功能障碍（ED）较少，心血管风险较低。肾移植受者中的FMD往往低于正常受试者，而同一组的内脂素水平与对照组相似。小儿RTx似乎对ESRD患儿的生长发育有积极影响。
