Garoufi Anastasia, Koumparelou Aikaterini, Askiti Varvara, Lykoudis Panagis, Mitsioni Andromachi, Drapanioti Styliani, Servos Georgios, Papadaki Maria, Gourgiotis Dimitrios, Marmarinos Antonios
Lipid Outpatient Unit, 2nd Department of Pediatrics, Medical School, National and Kapodistrian University of Athens (NKUA), "P. & A. Kyriakou" Children's Hospital, Thivon & Levadias Str., 11527 Athens, Greece.
2nd Department of Pediatrics, "P. & A. Kyriakou" Children's Hospital, 11527 Athens, Greece.
Children (Basel). 2022 Jun 19;9(6):916. doi: 10.3390/children9060916.
Pediatric chronic kidney disease (CKD) patients, as well as kidney transplant patients, are at an increased risk of developing cardiovascular disease. BNP measurement, as a biomarker of cardiovascular risk, has been recommended to this high-risk population. Plasma BNP levels were measured in 56 CKD children in either pre-dialysis stage, hemodialysis (HD) or renal transplant recipients (RTRs) and in 76 sex- and age-matched healthy controls. BNP levels were investigated in HD children, before and after the completion of their HD session. BNP levels in total CKD population, in pre-dialysis stage patients and on HD were significantly higher, compared to the respective controls. HD children had higher BNP levels compared to CKD patients in the pre-dialysis stage. Moreover, post-HD BNP concentration was slightly higher than pre-HD, with the difference being marginally statistically significant. BNP was positively correlated with eGFR, creatinine, cystatin-C and parathormone and negatively with albumin and 25-hydroxyvitamin D. A positive correlation between BNP concentration and the ratio of E/A in pulse-wave Doppler echocardiography was also observed. In conclusion, CKD pediatric patients, mainly those undergoing HD, have high plasma BNP levels which do not decrease after the HD session. This is indicative of a greater risk for future cardiovascular disease.
小儿慢性肾脏病（CKD）患者以及肾移植患者发生心血管疾病的风险增加。脑钠肽（BNP）检测作为心血管疾病风险的生物标志物，已被推荐用于这一高危人群。对56名处于透析前阶段、接受血液透析（HD）或肾移植受者（RTR）的CKD儿童以及76名性别和年龄匹配的健康对照者进行了血浆BNP水平检测。对HD儿童HD治疗前后的BNP水平进行了研究。与相应对照组相比，CKD总体人群、透析前阶段患者和接受HD治疗患者的BNP水平显著更高。与透析前阶段的CKD患者相比，HD儿童的BNP水平更高。此外，HD治疗后BNP浓度略高于HD治疗前，差异具有微弱的统计学意义。BNP与估算肾小球滤过率（eGFR）、肌酐、胱抑素-C和甲状旁腺激素呈正相关，与白蛋白和25-羟基维生素D呈负相关。在脉冲波多普勒超声心动图中还观察到BNP浓度与E/A比值之间呈正相关。总之，CKD小儿患者，主要是那些接受HD治疗的患者，血浆BNP水平较高，且HD治疗后并未降低。这表明其未来发生心血管疾病的风险更大。
