Navegando por Palavras-chave "Flow Mediated Dilatation"

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    Avaliação da vasodilatação mediada por fluxo artéria braquial e dos fatores de risco cardiovascular em crianças e adolescentes com doença renal crônica
    (Universidade Federal de São Paulo (UNIFESP), 2019-04-04) Bocaletti, Ana Paula [UNIFESP]; Ajzen, Sergio Aron [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Cardiovascular morbidity and mortality are the leading causes of death in children and young adults with advanced chronic kidney disease (CKD) diagnosed in childhood. Individuals with impairment of endothelial function and carotid intima-media thickness have an increased cardiovascular risk in the future. High resolution ultrasonography is a useful noninvasive method to investigate subclinical atherosclerosis by measuring the intima-media thickness of carotid artery and evaluating the brachial flow-mediated vasodilation (FMD). Objectives: Estimate the prevalence of FMD reduction in pediatric patients with advanced chronic kidney disease and verify the association between FMD reduction, clinical, anthropometric, laboratory parameters and intima-media thickness. Methods: In this cross-sectional study 55 patients (60% male), age 6.2-17.4 years, 43 with non-dialysis CKD and 12 on chronic dialysis were included in the analysis. FMD was evaluated 60 seconds after cuff release and was reduced when less or equal to 5%, compared with the baseline parameters. Intima-media thickness of carotid artery complex was performed on the posterior wall, on the longitudinal axis. Results: The prevalence of FMD reduction (≤ 5%) at 60 seconds was 41.8% (95% CI). Systemic arterial pressure (p = 0.041) and hemodialysis treatment (p<0,001) was significant correlated was with FMD reduction, as the glomerular filtration rate (p = 0.001) in patients on conservative treatment. The correlation between FMD reduction and carotid ECMI were not statistically significant. No statistical significance was observed between reduction of vasodilatation with sex, age, etiology of renal disease, time of diagnosis of renal disease, conservative or dialytic treatment, use of medications and changes in the serum biochemical levels studied. Conclusions: The prevalence of endothelial disfunction due to brachial FMD reduction was 41.8% in pediatric patients with chronic kidney disease. There was significant correlation between FMD reduction and glomerular filtration rate, blood pressure (BP) and hemodialysis. BP and hemodialysis were independently associated with FMD reduction. There was no significant correlation between carotid ECMI (morphological parameter) and FMD reduction (functional parameter). No statistical significance was observed between FMD reduction and renal disease etiology, time of diagnosis of renal disease, conservative or dialytic treatment, use of drugs and serum biochemical levels studied.