Cardiovascular Outcomes of Nephrotic Syndrome in Childhood (CVONS) Study: a Protocol for Prospective Cohort Study

Overview

Journal BMC Nephrol

Publisher Biomed Central

Specialty Nephrology

Date 2018 Apr 5

PMID 29614967

Citations 4

Authors

S K Patnaik

P Kumar

M Bamal

S Patel

M P Yadav

V Kumar

A Sinha

A Bagga

M Kanitkar

Affiliations

Soon will be listed here.

Abstract

Background: Nephrotic syndrome (NS) is characterized by dyslipidemia which is a well-known risk factor for atherogenesis. Atherosclerosis in childhood is mostly subclinical and endothelial dysfunction is known to precede this. Evidence for screening for endothelial dysfunction and cardiovascular risk factors and early identification of premature onset of atherosclerosis in childhood NS remains tenuous in the absence of well-designed prospective studies addressing cardiovascular comorbidity in NS. The objective of our study is to examine endothelial dysfunction and short-term cardiovascular outcomes in a carefully phenotyped cohort of patients with Nephrotic syndrome as compared to healthy controls.

Methods: In a multi-centric prospective cohort study, 70 Steroid Resistant NS (SRNS), 70 Steroid Sensitive (SSNS) patients along with 70 Healthy Controls are being recruited. After a baseline assessment of functional and structural status of heart (2D Echocardiography), arteries (Carotid Doppler and Intima Media Thickness measurements) and microcirculation [a combination of 2D Echocardiography, Laser Doppler Flowmetry (LDF) and Brachial Artery Flow mediated dilation (FMD) and Nail Fold Capillaroscopy (NFC)], the patients are being investigated for endothelial dysfunction. Venous blood sample (15 ml) is being collected for routine investigations and assay of biochemical endothelial markers through Flow Cytometry. The patients will be followed up at 12 months and 24 months after the recruitment to look for any change from baseline period.

Discussion: This study will able to provide a better understanding of the epidemiology of endothelial dysfunction and associated subclinical cardiovascular co-morbidity in childhood NS. Findings on characterization of prevalence of endothelial dysfunction and subclinical markers may be used to design future randomized controlled trials for evaluating the efficacy of preventive and therapeutic interventions in reducing the incidence of cardiovascular disease.

Citing Articles

Subclinical systolic dysfunction in children with steroid-resistant nephrotic syndrome identified by speckle tracking echocardiography.

Mahgoob M, Setouhi A BMC Pediatr. 2025; 25(1):91.

PMID: 39905382 PMC: 11792370. DOI: 10.1186/s12887-025-05449-3.

Arterial Stiffness and Cardiac Functions in Children with Idiopathic Nephrotic Syndrome.

Leventoglu E, Kavgaci A, Incedere F, Tokgoz S, Buyukkaragoz B Indian J Pediatr. 2023; 90(4):413.

PMID: 36757653 DOI: 10.1007/s12098-023-04500-4.

Prevalence and determinants of peripheral arterial disease in children with nephrotic syndrome.

Akinyosoye G, Solarin A, Dada A, Adekunle M, Oladimeji A, Owolabi A PLoS One. 2022; 17(8):e0266432.

PMID: 35951636 PMC: 9371348. DOI: 10.1371/journal.pone.0266432.

Disease-Associated Systemic Complications in Childhood Nephrotic Syndrome: A Systematic Review.

Hilmanto D, Mawardi F, Lestari A, Widiasta A Int J Nephrol Renovasc Dis. 2022; 15:53-62.

PMID: 35241925 PMC: 8887965. DOI: 10.2147/IJNRD.S351053.

Hypertension in Childhood Nephrotic Syndrome.

Shatat I, Becton L, Woroniecki R Front Pediatr. 2019; 7:287.

PMID: 31380323 PMC: 6646680. DOI: 10.3389/fped.2019.00287.

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