Role of regulatory cells in vasculopathy depend chronic kidney disease

Cardiovascular diseases are an important risk factor for morbidity and mortality on patients with chronic kidney disease (CKD). On patient with CKD, in general cardiovascular diseases (CVD) began as hidden and it has caused of heavy mortality in children. A variety of metabolic and immunologic factors in the development of CVD is being advocated and in which stage begins early cardiovascular involvement is not known. It's reported that T lymphocytes and their subgroups (Th1, Th2, Th17), B lymphocytes and their subgroups and their cytokines are contributed to CKD dependent CVD and atherosclerosis. But, there are no clear knowledge about cellular mechanism of immune cells and their cytokines in CVD and atherosclerosis. In this study we want to determine CVD involvement begin which stage of CKD with using arterial stiffness marker ex. Aix (Augmentation Index), PWV (Pulse Wave Velocity), CIMT (Carotis Intima-Media Thickness), LVMI (Left Ventricul Mass Index) and determine relation between Treg (Regulatory T cell) levels and CVS involvement in those stages in children with CKD. Cardiovascular involvement assessment test which listed above was applied and flow cytometric test was applied to determine Treg levels of each patient and control groups. First, CKD staging were made according to K/DQOI criteria in patient. Patients were classify in accordance with CKD stage. Stage 1,2,3 CKD patients were attached to group 1 and stage 4,5 patients were attached to group 2. When the group 1 and group 2 patients evaluated any CVS involvement in cardiovascular parameters, AIX average, average PWV, the average CIMT, the average LVMI was higher and that value is significantly higher than the healthy group (p<0,05). Group 1 and group 2 compared themselves AIX average value of the group 2 which is significantly higher than group 1 (p <0.05); The average PWV, the average was higher in the value of CIMT and the average LVMI but were not found statistically significant (p> 0.05). Patients in both groups, CD4 + CD25 + FoxP3 + cells Treg) that were analyzed was found to be significantly lower than normal levels of value (p<0,05).Group 2 patients CD4 + CD25 + FoxP3 + Treg cell level compared with patients in group 1 was found to be lower (p<0,05). In the literature there are no reports describing CKD dependent CVD on whether the cellular mechanism of the role of Treg cells. In this study we determined when the stage of the disease was increased, cardiovascular involvement was increased and Treg cells level was decreased. We think that Treg cells may play role in cardiovascular involvement on children with CKD based on this result. The results that obtained in this studies also support the proposed hypothesis. It was determined that as the stage of the disease increased, Treg cells level declined and cardiovascular risk was increased.