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胆钙化醇对慢性肾脏病患儿局部动脉硬化和血管内皮功能障碍的影响

作者:刘爽 编译 来源: 日期:2016-04-29
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Pediatric Nephrology
February 2016, Volume 31, Issue 2, pp 267-277
Effect of cholecalciferol on local arterial stiffness and endothelial dysfunction in children with chronic kidney disease
Mehmet Baha Aytaç , Murat Deveci, Kenan Bek, Özlem Kayabey
Abstract
Background
As cardiovascular factors are the leading cause of mortality in chronic kidney disease (CKD) and as vitamin D deficiency is prevalent in this population, we aimed to examine the effect of oral cholecalciferol on cardiac parameters and biomarkers for endothelial cell activation in children with CKD.
Methods
Forty-one children with CKD and 24 healthy subjects free of any underlying cardiac or renal disease with low 25-hydroxyvitamin D3 (25OHD) levels were evaluated using echocardiography basally and following Stoss vitamin D supplementation. The local vascular stiffness and endothelial dysfunction markers were compared among the groups.
Results
Initial flow-mediated dilatation (FMD) measurements were lower and local arterial stiffness was significantly higher in patients. After vitamin D supplementation, these improved significantly in patients, while no significant change was observed for the healthy group. Homocysteine showed inverse correlation with baseline vitamin D level in CKD children and von Willebrand factor emerged as an independent risk factor for FMD impairment.
Conclusions
Our interventional study revealed the favorable effects of high-dose cholecalciferol on cardiovascular and endothelial parameters, implying the importance of vitamin D supplementation in children with CKD.

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