Endothelial Dysfunction in Children with Frequently Relapsing and Steroid-Dependent Nephrotic Syndrome.

Background: Children with frequently relapsing (FR) or steroid-dependent (SD) nephrotic syndrome (NS) show endothelial dysfunction and risk of endothelial injury during relapses, increasing the risk of accelerated atherosclerosis and adverse cardiovascular events. This study examines the plasma levels of markers of endothelial dysfunction [sE-selectin and vascular cell adhesion molecule-1 (VCAM-1)] in children aged 1-16 years with FRNS and SDNS in relapse.

Materials and methods: Fifty-six children with FRNS and SDNS between 1 and 16 years were enrolled at the time of relapse and followed till six weeks of steroid-induced remission. Markers of endothelial dysfunction (sE-selectin and VCAM-1) in plasma were measured in these children and in an equal number of controls.

Results: Plasma sE-selectin and VCAM-1 levels were significantly raised during relapse, declined after six weeks of steroid-induced remission, and became comparable to controls (p < 0.0001). We found high serum total cholesterol and triglycerides levels during relapse that remained elevated even after steroid-induced remission as compared to controls (p < 0.0001). Raised levels of these markers confirm endothelial dysfunction in FRNS and SDNS patients.

Conclusion: Children with FRNS and SDNS had endothelial dysfunction during relapse, which was largely dependent upon disease activity.