الفهرس 
Introduction & aim of the workOnly 14 pages are availabe for public view
 |  | from | 184 |  |  |
| | | from | 184 | | |
Abstract
Chronic kidney disease is a major pediatric health problem that has a bad social an economic burden worldwide. Several complications may take place along the course of CKD, of them CVC are the most important even with mild renal impairment. CVC are important causes for CKD associated mortality; that may precede the progression to ESRD. Nephrotic syndrome also has an increased CVC incidence that was explained by associated hyperlipidemia and HTN. A simple applicable way to assess these CKD associated CVC is the local assessment of AS as a nontraditional risk factor for CVC. Increased AS is an early marker of increased CVR in CKD patients.
In this study we tried to find an easy method that can be applied in daily clinical practice to define the early vascular changes that precedes these complications, using M-mode ultrasound. Our 75 patients were classified in to 3 groups of cases; 25 SRNS patients, 25 CKD G2-4 patients and 25 ESRD on hemodialysis patients. The 3 groups were compared to 25 healthy control patients with excluded renal affection. Growth parameters and BP indices were taken. Different laboratory parameters “CBC, lipid profile, bone profile, iron kinetics, albumin and urine analysis” together with the ultrasonographic assessment of AS indices of both carotid and femoral arteries using M - mode ultrasound were used to prove the increased premature CVR in CKD pediatric populations. Our study supported the evidence of increased carotid artery stiffness in SRNS, CKD and ESRD patients in comparison to control; C.dd were statistically higher in the 3 groups in comparison to control group. All carotid stiffness indices “CWS, CC, CEM and Cβ” showed significant differences between SRNS and control groups. Also, CC and CEM showed significant differences between CKD and control groups. All carotid stiffness indices “CWS, CC, CEM and Cβ” showed significant differences between ESRD and control group. Also, our study proved the increased stiffness of femoral artery in SRNS, CKD and ESRD patients in comparison to control; F.dd were statistically higher in CKD and ESRD group in comparison to control group. Also, ESRD F.dd was statistically higher in comparison to SRNS group. All femoral stiffness indices “FWS, FC, FEM and Fβ” showed significant differences between “SRNS, CKD and ESRD” and control groups. Our study has explained the increased AS in SRNS group by the associated hyperlipidemia and HTN. As regard CKD and ESRD ; AS was explained by HTN, elevated phosphorus levels and Ca*P. Measuring AS along the follow up period of CKD patients can provide a useful data for early vascular changes before evident CVC independent of other traditional CVR factors.