The evaluation of endothelial damage in pediatric renal transplant recipients

Circulating Endothelial Cells (CEC) were reported to be important for the evaluation of endothelial damage in cardiovascular disease. The aim of the study was evaluation of endothelial damage in pediatric renal transplant recipients with CEC numbers and the correlation between D vitamin levels and endothelial damage.CEC were studied by flow-cytometry at 50 pediatric renal transplant recipients and 20 healthy controls with the use of anti-CD146 ve anti-CD45 monoclonal antibodies. CEC were defined as CD146(+)CD45(-) cells in peripheric blood. Demographic features of patients were reported from the medical records. Renal function tests, fasting bloood glucose, serum cholesterol, triglyceride and 25(OH)D3 vitamin levels were sudied. Estimated glomerular filtration rate(eGFR) was calculated with Schwartz formula. Patient group was categorised according to the 25(OH)D3 vitamin levels as normal and deficient /insufficient. CEC numbers were compared between groups.Twenty patients were boys (%54) and mean ages of all patients were 14.7±3.7 years. Nine of the control group were boys(%45) ,mean ages of control group were 13.1±3.4 years. CEC numbers of patient group were higher than controls (respectively; 128 ± 89 cells/ml ( 42-468cells/ml), 82±33cells / ml (32-137 cells/ml), p=0.024). There was statistically significant negative correlation between CEC numbers and GFR(r =-0.300, p=0.012). There was statistically possitive correlation between CEC numbers and transplant duration, cyclosporine through level (respectively; r=0.397, p=0.004 ve r= 0,714, p=0,004). CEC numbers of patients on tacrolimus and cyclosporine were similar(p=0.716). There was no statistically significant difference according to donor type, acute rejection history, hypertension occurrance, hypertriglyceridemia and hypercholesterolemima. There was no statistically significant correlation between CEC numbers and serum calcium, phosphorus, uric acid, triglyceride, chlosterol, fasting blood glucose, CRP, sedimentation.Five patients had normal vitamin D levels. Fourteen of patients had vitamin D insufficiency and 31 had deficiency. There was no correlation between CEC numbers and vitamine D levels( p=0,867).Endothelial damage is higher in pediatric renal transplant recipients than control group. Posttransplant duration and cyclosporine through level were risk factors for endothelial damage. Vitamin D deficiency/ insufficiiency is high in pediatric renal transplant recipients. There was no correlation between endothelial damage and D vitamin levels.