Background Premature atherosclerosis and cardiovascular morbidity are known in adults with Systemic Lupus Erythematosus (SLE); however, there is paucity of data in Indian children with lupus nephritis (LN), who may be at higher cardiovascular risk due to ethnic differences. Methods This cross-sectional study was conducted at the pediatric nephrology clinic of a referral hospital in south India. Forty children with LN >1 year disease duration and 40 healthy-controls were enrolled. Brachial artery flow-mediated dilatation (FMD), carotid intima medial thickness (cIMT), and echocardiography for left ventricular (LV) mass, LV systolic and diastolic function, and global-longitudinal-strain (GLS) were done. Results Mean age at SLE and LN diagnosis were 10.07 years and 10.68 years respectively, with median LN disease duration of 3.2 years. Class 3 and Class 4 LN accounted for 67.5% of the cases. Overall, 6 (15%) LN cases had concentric LVH, while 4 (10%) had biplane ejection fraction≤ 55%. Mean resting brachial artery diameter was lower in cases ( n = 40) than age and sex-matched healthy-controls ( n = 40) (2.7 mm vs 2.9 mm, p 0.010 ), although median proportionate change in FMD was comparable 13.84% (8.17%, 20.31%) versus 14.49% (12.21%, 17.24%); p 0.413 . However, proportionate change in FMD 1 year disease duration demonstrate significant cardiovascular comorbidities, including evidence of endothelial dysfunction, as well as LV systolic and diastolic dysfunction.
Ramaswamy et al. (Sat,) studied this question.