Carotid intima-media thickness in children with nephrotic syndrome: a cross-sectional study compared with healthy children

Abstract Background Idiopathic nephrotic syndrome (INS) is a common childhood kidney disorder that increases the risk of cardiovascular disorders (CVD) due to hyperlipidemia and hypertension. Elevated carotid intima-media thickness (CIMT) indicates early vascular changes. This study aimed to evaluate the CIMT in children with INS and correlate it with some CVD risk factors. Methods This cross-sectional study enrolled 35 children diagnosed with INS who had been observed for a minimum of one year at the nephrology clinic, along with 35 matched healthy individuals. All participants underwent physical examinations and tests, including a lipid profile, renal function, serum albumin, hemoglobin levels, and an ultrasound to measure CIMT. Results The study included patients with a mean age of 7.9 ± 4.3 years, primarily males, with an average INS duration of 4.21 ± 2.25 years. The study didn’t find a significant difference in BMI between the two groups ( p = 0.06). However, the patients had a significantly higher mean diastolic blood pressure (BP) than the controls ( p = 0.001), while no notable difference was observed in mean systolic BP between both groups. The study found that patients with INS had a mean CIMT of 0.42 ± 0.08 mm (95% CI 0.39–0.45), significantly higher than the control group's 0.35 mm ± 0.023 (95% CI 0.34–0.36) ( p < 0.001). There was a positive correlation between CIMT and the patient's age ( r = 0.52, p < 0.001), disease duration ( r = 0.457, p = 0.006), and low-density lipoprotein ( r = 0.67, p < 0.001), while CIMT negatively correlated with high-density lipoprotein (r = -0.58, p < 0.001), urinary albumin-creatinine ratio ( r = -0.49, p = 0.002), and serum hemoglobin levels ( r = -0.553, p = 0.001). Conclusions Children with INS are not exactly at higher risk for dyslipidemia, but this can be part of the syndrome. CIMT measurement enables early detection of cardiovascular complications in children with INS.