Liao Wei-Ting, Chen Wei-Ling, Tain You-Lin, Hsu Chien-Ning
Division of Pediatric Nephrology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.
College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Biomedicines. 2022 Jun 13;10(6):1396. doi: 10.3390/biomedicines10061396.
Cardiovascular disease (CVD) is the main cause of mortality among chronic kidney disease (CKD) patients, both in adults and in children. Hypertension is one of the risk factors of CVD. For early detection of subclinical CVD in pediatric CKD, 24 h ambulatory blood pressure monitoring (ABPM), cardiosonography, and arterial stiffness assessment were evaluated. CAKUT (congenital anomalies of the kidney and urinary tract) are the main etiologies of pediatric CKD. Previously, by a proteomic approach, we identified complement factor H (CFH) and related proteins differentially expressed between children with CAKUT and non-CAKUT CKD. In this study, we aimed to evaluate whether CFH, CFH-related protein-2 (CFHR2), and CFH-related protein-3 (CFHR3) were related to CVD risk in children with CKD. This study included 102 subjects aged 6 to 18 years old. The non-CAKUT group had higher plasma CFHR3 levels than the CAKUT group (p = 0.046). CFHR3 was negatively correlated with LV mass (p = 0.009). CFHR2 was higher in children with CKD with 24 h hypertension in the ABPM profile (p < 0.05). In addition, children with non-CAKUT CKD with day-time hypertension (p = 0.036) and increased BP load (p = 0.018) displayed a lower plasma CFHR3 level. Our results highlight that CFH and related proteins play a role for CVD in children with CKD. Early assessment of CFH, CFHR2, and CFHR3 may have clinical utility in discriminating CV risk in children with CKD with different etiologies.
心血管疾病（CVD）是慢性肾脏病（CKD）患者（包括成人和儿童）死亡的主要原因。高血压是CVD的危险因素之一。为了早期检测儿童CKD中的亚临床CVD，对24小时动态血压监测（ABPM）、心脏超声检查和动脉僵硬度评估进行了评价。先天性肾脏和尿路异常（CAKUT）是儿童CKD的主要病因。此前，我们通过蛋白质组学方法，鉴定了CAKUT患儿和非CAKUT CKD患儿之间差异表达的补体因子H（CFH）及相关蛋白。在本研究中，我们旨在评估CFH、CFH相关蛋白2（CFHR2）和CFH相关蛋白3（CFHR3）是否与CKD患儿的CVD风险相关。本研究纳入了102名6至18岁的受试者。非CAKUT组的血浆CFHR3水平高于CAKUT组（p = 0.046）。CFHR3与左心室质量呈负相关（p = 0.009）。ABPM显示24小时高血压的CKD患儿CFHR2水平较高（p < 0.05）。此外，非CAKUT CKD且伴有日间高血压（p = 0.036）和血压负荷增加（p = 0.018）的患儿血浆CFHR3水平较低。我们的结果表明，CFH及相关蛋白在CKD患儿的CVD中起作用。早期评估CFH、CFHR2和CFHR3可能在鉴别不同病因的CKD患儿的心血管风险方面具有临床应用价值。
