A Study of Vascular Reactivity Change in Nephrotic Syndrome Children Using Plethysmography

Shim, Jae Won; Yoo, Byoung Hoon; Lim, In Suk

Abstract

PURPOSE: The nephrotic syndrome is characterized by proteinuria, hypoproteinemia, edema and hyperlipidemia. These can change body homeostasis and cause hypertension. This study was designed to determine the relationship between the forearm vasodilating capacity and serum cholesterol level of nephrotic syndrome patients.
METHODS
15 Nephrotic syndrome patients and 17 normal control children who visited Chung-ang University Youngsan Hospital from Sep. 1995 to Sep 1996, were investigated. Each subject underwent forearm plethysmography for mearsurement of blood flow and vascular resistance.
RESULTS
1) Resting blood pressure, heart rate, forearm blood flow, vascular resistance was not significantly different in nephrotic syndrome group and control group. 2) After peak hyperemic periods, blood pressure, heart rate was not significantly different in nephrotic syndrome group and control group. 3) After hyperemic periods, peak forearm vascular blood flow was lower in nephrotic syndrom group (52.0+/-10.6mL/min/100ml) than control group (59.5+/-4.5mL/min/100mL), and minimal forearm vascular resistance was significantly higher in nephrotic syndrome group (1.8+/-0.5mmHg/mL/min/100mL) than control group (1.5+/-0.4mmHg/mL/min/100mL) (p<0.05). 4) vascular dilatation capacity (resting-hyperemic forearm vascular resistance difference) was also significantly lower in nephrotic syndrome group (6.3+/-1.6mmHg/mL/min/100) than control group. 5) Serum cholesterol level is significantly higher in nephrotic syndrome group (253.1+/-133.4mg/dL) than control group (183.5+/-41.0mg/dL). High cholesterol level related with nephrotic duration. 6) resting-hyperemic forearm vascular resistance difference is associated with relapsing frequence, but not associated with cholesterol level and nephrotic syndrome duration.
CONCLUSIONS
These data suggest that reactive vascular changes in the forearm of nephrotic syndrome demonstrate early abnormalities of subclinical vascular changes, and these vascular change may contribute to cardiovacular disease and artherosclerosis.