Early Prediction of Premature Atherosclerosis in Children with End Stage Renal Disease(ESRD) on Regular Haemodialysis, A Single Centre Experience

Introduction: Chronic renal failure is associated with atherosclerosis and increased incidence of cardiovascular morbidity and mortality.The aim of this work was to compare between children with ESRD under regular HD and healthy controls as regard serum levels of lipids as early predictors of premature atherosclerosis proven by common carotid intima-media thickness (CCA -IMT).Methods: The present study was carried out on 45 children with ESRD on regular hemodialysis in an University hospital and 30 healthy age and sex matched children were serving as controls.All subjects were subjected to thorough history taking, clinical examination including anthropometric measurement and blood pressure measurements, routine laboratory assessments measuring complete blood picture, C-reactive protein, blood urea and serum Creatinine, lipid profile including serum levels of total cholesterol, triglycerides(TG), low density lipoprotein (LDL) and high density lipoprotein (HDL)and radiological assessment using B-mode Doppler ultrasonography to measure common carotid artery intima media thickness (CCA-IMT) to detect presence and extent of atherosclerosis.Results: There was significant increase in serum levels of triglyceride, cholesterol and LDL and a significant decrease in HDL in dialysis children when compared to healthy controls.There was also a highly significant increase in CCA-IMT of the patients group when compared to the controls (P < 0.001) with significant positive correlation with duration of dialysis and serum TG and a significant negative correlation with serum HDL.Conclusions: Increased serum levels of TG, cholesterol, LDL and decreased serum level of HDL are early predictors for premature atherosclerosis in children with ESRD.