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

Journal of the Korean Pediatric Society 1997;40(5):650-659.
Published online May 15, 1997.
A Study of Vascular Reactivity Change in Nephrotic Syndrome Children Using Plethysmography
Jae Won Shim, Byoung Hoon Yoo, In Suk Lim
Department of Pediatrics, College of Medicine, Chung Ang University, Seoul, Korea
소아 신증후군 환자에서 plethysmography를 이용한 혈관반응성에 대한 연구
심재원, 유병휸, 임인석
중앙대학교 의과대학 소아과학교실
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¡¾10.6mL/min/100ml) than control group(59.5¡¾4.5mL/min/100mL), and minimal forearm vascular resistance was significantly higher in nephrotic syndrome group (1.8¡¾0.5mmHg/mL/min/100mL) than control group(1.5¡¾0.4mmHg/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¡¾1.6mmHg/mL/min/100) than control group. 5) Serum cholesterol level is significantly higher in nephrotic syndrome group(253.1¡¾133.4mg/dL) than control group(183.5¡¾41.0mg/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.
Conclusion
: 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.
Key Words: Nephrotic syndrome, Hyperlipemia, Artherosclerosis, Plethysmography


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