Ankle Brachial Index in Children with Steroid-Resistant Nephrotic Syndrome

Abstract

Objectives: This study aimed to assess the ankle brachial index (ABI) as a predictor of peripheral arterial diseases (PAD) in children with steroid-resistant nephrotic syndrome (NS). Methods: Twenty children (11 males and 9 females) attending the Pediatric Nephrology Outpatient Clinic of El-Minia University Hospital, Egypt, were enrolled in this study. Their age ranged between 5 and 15 years with a mean of 10.75 ± 3.31 years. They had proteinuria and were dependent on steroid therapy. Twenty healthy age- and sex-matched children served as a control group. All patients and controls underwent a thorough history-taking and clinical examination. All subjects in the study underwent laboratory investigations, including a urine analysis (24-hour test for protein in urine, and levels of serum urea and creatinine, triglycerides, and cholesterol). A renal biopsy was done to diagnose the children’s histopathological type of NS. A Doppler study was done to determine patients’ ABI. Results: ABI was significantly higher in the patient group than in the control group (P <0.0001). There was a negative correlation between ABI and duration of treatment (r value = 0.77 and P <0.001). Conclusion: ABI is simple non-invasive manoeuvre that can reliably assess arterial stiffness as an early predictor of atherosclerosis in nephrotic patients with long duration of both illness and steroid therapy.