ABSTRACT
Cardiovascular disease (CVD) is the most important risk factor for morbidity and mortality in patients with chronic kidney disease (CKD). Aim of this study was to evaluate cardiac and vascular geometry in children with CKD stages 2, 3 and 4.Twenty-seven patients (18 males and 9 females) mean age 10.9 +/- 5.4 years with CKD and 30 children (control group) were enrolled with comparable age and sex. Weight, height, systolic and diastolic blood pressure were evaluated. We also analyzed biochemical assessments and proteinuria. We performed echocardiography with Philips iE33 and pulse wave velocity (PWV) with Vicorder PWS system. We documented significantly higher level of left ventricular mass index (LVMI) (30.3 +/- 7.6 g/m2.7) and PWV (4.7 +/- 1.6 m/sec) in CKD patients. Left ventricular hypertrophy (LVH) was present in 12 % and concentric remodelling in 36% of our patients. PWV values were significantly correlated with interventricular septal thickness (p<0.01) and with LVMI (p<0.05). In this study we documented the alterations of cardiac and vascular geometry since the early stages of CKD. PWV and echocardiographic measurements must be considered to assess cardiovascular risk in children with CKD stages 2-4.
Subject(s)
Cardiovascular Diseases/etiology , Renal Insufficiency, Chronic/complications , Cardiovascular Diseases/epidemiology , Case-Control Studies , Child , Female , Humans , Male , Renal Insufficiency, Chronic/diagnosis , Risk Factors , Severity of Illness IndexABSTRACT
Celiac Disease is a worldwide spread condition affecting 1:100-1:200 individuals. It is a permanent food intolerance to ingested gluten in genetically predisposed subjects. In this review we analyze the biochemical markers of the disease going from laboratory findings to histology passing through genetics. Gluten intolerance is a unique model of autoimmune disease in which we can recognize the main environmental factor (gluten) and the more complex genetic background. In additional way, serological markers for monitoring the disease and a safe and effective therapy (gluten free diet) are also available. In deed the environmental factor such as gluten intake is necessary to trigger the disease but genetics also matter. HLA genes are the most studied but in recent times also not HLA related genes are giving proof of additional relative risk to disease if present. From histological point of view intra epithelial cell infiltration by several lymphocyte subsets is becoming more and more important also for understanding pathogenesis of the disease.
Subject(s)
Biomarkers/metabolism , Celiac Disease/blood , Celiac Disease/physiopathology , Celiac Disease/genetics , Epithelial Cells/immunology , Humans , Lymphocyte Subsets/immunology , Serology/methodsABSTRACT
Celiac Disease is a worldwide spread condition affecting 1:100-1:200 individuals. It is a permanent food intolerance to ingested gluten in genetically predisposed subjects. In this review we analyze the biochemical markers of the disease going from laboratory findings to histology passing through genetics. Gluten intolerance is a unique model of autoimmune disease in which we can recognize the main environmental factor (gluten) and the more complex genetic background. In additional way, serological markers for monitoring the disease and a safe and effective therapy (gluten free diet) are also available. In deed the environmental factor such as gluten intake is necessary to trigger the disease but genetics also matter. HLA genes are the most studied but in recent times also not HLA related genes are giving proof of additional relative risk to disease if present. From histological point of view intra epithelial cell infiltration by several lymphocyte subsets is becoming more and more important also for understanding pathogenesis of the disease.
