The Relationship Between Serum Asymmetric Dimethylarginine Levels and Cardiovascular Risk Factors in Children with Nephrotic Syndrome

Aim: Nephrotic syndrome is a common type of kidney disease during childhood characterized by proteinuria, edema and hypoalbuminemia. Serum asymmetric dimethylarginine (ADMA) inhibits vascular nitric oxide production and may be an independent risk factor for coronary heart disease. The aim of this study was to investigate the relationship between ADMA and atherosclerotic risk factors in children with nephrotic syndrome. Methods: Forty-one children with nephrotic syndrome and 33 healthy children were included in the study. Patients' demographic and anthropometric characteristics, biochemical tests, serum homocysteine, ADMA and carotid intima-media thickness (CIMT) were assessed. The patients were divided into three groups: group 1 - steroid-free remission; group 2 - steroid-induced remission, still on steroid therapy; and group 3 - active proteinuria. Results: The patient and control groups were similar in terms of age, sex, weight, height, body mass index, and systolic blood pressure (p>0.05). Diastolic blood pressure was significantly higher in children with nephrosis than in controls. Serum ADMA, homocysteine and CIMT measurements were not different between the two groups (p>0.05). There was a positive correlation between diastolic blood pressure and CIMT measurement in patients. In group 3, ADMA was positively correlated with total cholesterol and low density lipoprotein cholesterol. Conclusion: Children with idiopathic nephrotic syndrome did not show signs of endothelial damage assessed by ADMA and CIMT.