الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Nephrotic syndrome is among the most common pediatric kidney diseases with a high risk of morbidity and mortality. Children with NS suffer from comorbidities related to medication side effects and the NS disease pathophysiology, many of which are known to increase cardiovascular disease risk including obesity, left ventricular hypertrophy (LVH), increased measures of arterial stiffness (increased carotid intima-media thickness ( cIMT), endothelial dysfunction), hypertension, impaired glucose metabolism, and hyperlipidemia, so screening for endothelial dysfunction and cardiovascular risk factors and early identification of premature onset of atherosclerosis in childhood NS is very important.
The aim of the present study was to assess the carotid intima-media thickness and left ventricular mass index and their relation to clinical and biochemical parameters in children with idiopathic nephrotic syndrome and to evaluate the effect of nutritional modification and antihyperlipidemic drugs in controlling their abnormal lipid profile.
The present study included 100 children with nephrotic syndrome attending AUCH, divided into two groups, group A included 50 cases diagnosed as SRNS and group B, included 50 steroid dependent NS (34 cases) and frequently relapsing NS (16 cases), and 100 matched children for age and sex as control group.
All nephrotic children in this study were subjected to thorough history taking, clinical examination stressing on anthropometric measures, blood pressure measurement and laboratory investigations including, 24- hours urine protein measurement, serum urea, serum creatinine, serum albumin, C3, ANA, Anti-dsDNA, Hepatitis B, C serology. Lipid profile, fasting blood glucose, fasting insulin, ultrasonographic study of carotid intima-media thickness and echocardiography to assess the left ventricular mass.
According to the new blood pressure classification, 76% of our nephrotic children had normal blood pressure while 1% had elevated blood pressure, 18% had stage 1 hypertension and 5% had stage 2 hypertension. There was no significant difference regarding blood pressure between group A and group B.
Nephrotic children of the present study showed abnormal lipid profile in comparison to control group. Mean levels of cholesterol, triglycerides, LDL-C and VLDL-C were significantly higher in nephrotic children than control group. Total cholesterol and LDL-C were significantly higher in group Steroid resistant cases (group A) than group B.