Evaluation of suPAR and SIRT1 as Cardiovascular Markers in Pediatric Patients with Chronic Renal Failure

Chronic Kidney Disease (CKD) characterized by kidney damage, resulting in progressive and irreversible loss of renal function. Cardiovascular diseases are an important cause of morbidity and mortality in CKD. Soluble urokinase plasminogen activator receptor (suPAR) is an inflammation biomarker and its association with decreased glomerular filtration rate (GFR) has been reported. Sirtuin1 (SIRT1) plays a role in the response to oxidative stress and inflammation. The aim of this study was to compare serum suPAR and SIRT1 levels in children with and without chronic kidney disease and to evaluate whether there is a difference between patients with and without cardiovascular involvement. Material Method: This study was designed with total of 49 patients diagnosed with CKD and 20 healthy children in Ege University Faculty of Medicine, Department of Pediatric Nephrology. SIRT1 and suPAR levels were studied by ELISA method in Ege University Faculty of Medicine, Department of Medical Biology. Results: Of the 69 children (49 patients / 20 controls) included in the study, 35 were male and 34 were female. The mean age was 14.6 ± 5 years. The most common cause was urological abnormalities with a percent of 40.8% (n = 20) in terms of primary diseases causing chronic kidney disease. The mean SIRT1 levels of the patients were 8.01 ± 5.03; suPAR levels were 2.50 ± 2.85. Both parameters were similar to the control group (p = 0.444, p = 0.760). SIRT1 and suPAR levels of patients with CKD were similar in female and male sex and with urologic and non-urologic causes (p> 0.05). Serum suPAR and SIRT1 levels were similar according to CKD stages. When the patients were grouped as receiving and not receiving dialysis treatment; mean SIRT1, PWV (pulse wave velocity) and augmentation index (Aix) levels were similar in both groups (p> 0.05). The mean suPAR level of patients with dialysis was significantly lower than those without (p = 0.029). When the dialysis patients were compared with the control group, SIRT1 levels were similar (p> 0.05), while mean suPAR levels were significantly lower in the dialysis group (p = 0.043). SIRT1 and suPAR levels were similar in patients without dialysis and control group (p> 0.05). As a result; Serum suPAR and SIRT1 levels in children with CKD were similar to the control group. In addition, serum suPAR levels were significantly lower in the dialysis group compared to non- dialysis patients. We believe that studies involving more patients and control groups with multiple measurements may be useful. Keywords; Chronic Kidney Disease; children; suPAR; SIRT1