Intimal media thickness asymmetric dimethylarginine and nitric oxide level of neprotic sydrome child

Nephrotic syndrome is a clinical disease which is characterized by massive proteinuria that occurs as a result of an increase in permeability in glomerular filtration barrier; which causes hypoproteinemi, oedema and hyperlipidemia. It is thought that immunologic mechanisms, infectious agents and increased inflammatory reactions are responsible for the etiology of nephrotic syndrome. One of the important factors that is accused of being a reason of etiopathogenesis is endothelial dysfunction.Endothelial dysfunction causes a decrease in the synthesis of nitric oxide which is effective in vasodilatation and has a main role in the development of atherosclerosis. The NO (nitric oxide) which is produced by endothelial dysfunction, ADMA (asymmetric dimethylarginine) which is the inhibitor of NOS (nitric oxide synthase) and the distal carotis intimal media thickness in patients with nephrotic syndrome are importantly different from the healthy children. The elevation in plasma concentration of cholesterol, trigliserid, fosfolipid and fat acids results with endothelial dysfunction, increase in cardiovascular complications and intima media thickness.Our study group consist of 27 patients with NS and control group consists of 25 healthy children that referred to Dicle University Department of Pediatric Nefrology Policlinic from 2010 January to 2011 July. In our study, the age and sex of children, and their blood pressure, height and body weight have been recorded. By taking blood samples from children; complete blood count, urea, creatinine, albumin, calcium, phosphorus, uric acid, alkalen phospatase, parathormone, lipid profile, ferritine, vitamin B12, folic acid, hs-CRP, ADMA and NO levels have been measured and their glomerular filtration rate have been calculated. Distal carotis IMK of patient and healthy groups has been ultrasonographically measured.In the group with NS, after ultrasonographic measurements, right carotis IMK is measured as 0,363 ± 0,083 cm and left carotis IMK is measured as 0,374 ± 0,093 cm. In the control group, after ultrasonographic measurements, right carotis IMK is measured as 0,267 ± 0,048 cm and left carotis IMK is measured as 0,281 ± 0,068 cm. In the group with NS; the ADMA level is found as 0,924 ± 0,564 umol/L, NO level is found as 8,96 ± 4,46 ? M. Our study suggests that in children with NS, NO synthesis and distal carotis IMK have been increased and the level of ADMA hasn?t shown a significant difference in comparison with the control group.It has been thought that, in children with NS the diagnosis of endothelial dysfunction and investment of the reasons of cardiovascular morbidity and mortality in early phase by measuring the level of NO, ADMA and distal carotis IMK; and taking precautions for decreasing the complications, may assist children with their prognosis.Keywords: Nephrotic syndrome, nitric oxide, asymmetric dimethylarginine, intimal media thickness.