Skip to main content

Advertisement

SpringerLink
Log in

Acute reversible changes of brachial-ankle pulse wave velocity in children with acute poststreptococcal glomerulonephritis

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

Acute poststreptococcal glomerulonephritis (APSGN) is the most common form of postinfectious nephritis worldwide. The relationship between inflammation and arterial stiffness has been described elsewhere, but there have been no studies that have analyzed the association between arterial compliance and APSGN. The aim of this study is to assess brachial–ankle pulse wave velocity (baPWV) in pediatric patients with APSGN, and the value of baPWV in predicting the outcome. We evaluated 16 children diagnosed with APSGN, 11 children with acute pyelonephritis (APN), and 25 healthy individuals in our hospital. The baPWV of all candidates was measured. In addition, follow-up of the APSGN group was conducted for baPWV, blood pressure and biochemical parameters. Significantly increased baPWV was observed in the APSGN group at initial diagnosis (P < 0.001), in comparison with the APN group and healthy controls. Of these, 13 patients received sequential measurement of baPWV. Overwhelmingly, baPWV was rapidly normalized in 11 patients, whereas 2 boys presented with persistently higher baPWV. During the follow-up period of 2–3 years, both had consistency of proteinuria, and consequently, they progressed to either chronic renal insufficiency or end-stage renal disease (ESRD). In conclusion, the results demonstrate that APSGN involves not only the kidney, but also the arterials outside the kidney. Acute arterial stiffness might persist in patients who do not recover, but develop chronic kidney disease (CKD).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Wong W, Morris MC, Zwi J (2009) Outcome of severe acute post-streptococcal glomerulonephritis in New Zealand children. Pediatr Nephrol 24:1021–1026

    Article  PubMed  Google Scholar 

  2. Vogl W, Renke M, Mayer-Eicherger D, Schmitt H, Bohle A (1986) Long term prognosis for endocapillary glomerulonephritis of poststreptococcal type in children and adults. Nephron 44:58–65

    Article  CAS  PubMed  Google Scholar 

  3. White AV, Hoy WE, McCredie DA (2001) Childhood post-streptococcal glomerulonephritis as a risk factor for chronic renal disease in later life. Med J Aust 174:492–494

    CAS  PubMed  Google Scholar 

  4. Chugh KS, Malhotra HS, Sakhuja V, Bhusnurmath S, Singhal PC, Unni VN, Singh N, Pirzada R, Kapoor MM (1987) Progression to end stage renal disease in post-streptococcal glomerulonephritis (PSGN)—Chandigarh Study. Int J Artif Organs 10:189–194

    CAS  PubMed  Google Scholar 

  5. Clark G, White RH, Glasgow EF, Chantler C, Cameron JS, Gill D, Comley LA (1998) Poststreptococcal glomerulonephritis in children: clinicopathological correlations and long-term prognosis. Pediatr Nephrol 2:381–388

    Article  Google Scholar 

  6. Van Buynder PG, Gaggin JA, Martin D, Pugsley D, Mathews JD (1992) Streptococcal infection and renal disease markers in Australian aboriginal children. Med J Aust 156:537–540

    PubMed  Google Scholar 

  7. Rodriguez-Iturbe B, Musser JM (2008) The current state of post-streptococcal glomerulonephritis. J Am Soc Nephrol 19:1855–1864

    Article  PubMed  Google Scholar 

  8. Cleper R, Davidovitz M, Halevi R, Eisenstein B (1997) Renal function reserve after acute poststreptococcal glomerulonephritis. Pediatr Nephrol 11:473–476

    Article  CAS  PubMed  Google Scholar 

  9. Amar J, Ruidavets JB, Chamontin B, Drouet L, Ferrieres J (2001) Arterial stiffness and cardiovascular risk factors in a population-based study. J Hypertens 19:381–387

    Article  CAS  PubMed  Google Scholar 

  10. Meaume S, Rudnichi A, Lynch A, Bussy C, Sebban C, Benetos A, Safar ME (2001) Aortic pulse wave velocity as a marker of cardiovascular disease in subjects over 70 years old. J Hypertens 19:871–877

    Article  CAS  PubMed  Google Scholar 

  11. Guerin AP, Blacher J, Pannier B, Marchais SJ, Safar ME, London GM (2001) Impact of aortic stiffness attenuation on survival of patients in end-stage renal failure. Circulation 103:987–992

    CAS  PubMed  Google Scholar 

  12. Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K, Koji Y, Hori S, Yamamoto Y (2002) Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 25:359–364

    Article  PubMed  Google Scholar 

  13. Munakata M, Ito N, Nunokawa T, Yoshinaga K (2003) Utility of automated brachial ankle pulse wave velocity measurements in hypertensive patients. Am J Hypertens 16:653–657

    Article  PubMed  Google Scholar 

  14. Gonzalez R, Morales O, Delgado J, Padilla JM, Ferreo JM, Saiz J (2008) Automatic brachial ankle pulse wave velocity measurements for vascular damage assessments. Comput Cardiol 35:173–176

    Google Scholar 

  15. Niboshi A, Hamaoka K, Sakata K, Inoue F (2006) Characteristics of brachial-ankle pulse wave velocity in Japanese children. Eur J Pediatr 165:625–629

    Article  PubMed  Google Scholar 

  16. Wang CF, Su YT, Hsieh KS (2008) Reference values of brachial-ankle pulse wave velocity in children. Acta Cardiol Sin 24:35–38

    CAS  Google Scholar 

  17. Nordstrand A, Norgren M, Holm SE (1999) Pathogenic mechanism of acute post-streptococcal glomerulonephritis. Scand J Infect Dis 31:523–537

    Article  CAS  PubMed  Google Scholar 

  18. Viera N, Pedreanez A, Rincon J, Mosquera J (2007) Streptococcal exotoxin B increases interleukin-6, tumor necrosis factor alpha, interleukin-8 and transforming growth factor beta-1 in leukocytes. Pediatr Nephrol 22:1273–1281

    Article  PubMed  Google Scholar 

  19. Sie MP, Mattace-Raso FU, Uitterlinden AG, Arp PP, Hofman A, Pols HA, Hoeks AP, Reneman RS, Asmar R, van Duijn CM, Witteman JC (2008) The interleukin-6-174 G/C promoter polymorphism and arterial stiffness; the Rotterdam study. Vasc Health Risk Manag 4:863–869

    CAS  PubMed  Google Scholar 

  20. Silverstein DM (2009) Inflammation in chronic kidney disease: role in the progression of renal and cardiovascular disease. Pediatr Nephrol 24:1445–1452

    Article  PubMed  Google Scholar 

  21. Ljutić D, Kes P (2003) The role of arterial hypertension in the progression of non-diabetic glomerular disease. Nephrol Dial Transplant 18 [Suppl 5]:v28–v30

    Article  PubMed  Google Scholar 

  22. Martinez-Maldonado M (2001) Role of hypertension in progression of chronic renal disease. Nephrol Dial Transplant 16 [Suppl 1]:63–66

    PubMed  Google Scholar 

  23. ESCAPE Trial Group, Wühl E, Trivelli A, Picca S, Litwin M, Peco-Antic A, Zurowska A, Testa S, Jankauskiene A, Emre S, Caldas-Afonso A, Anarat A, Niaudet P, Mir S, Bakkaloglu A, Enke B, Montini G, Wingen AM, Sallay P, Jeck N, Berg U, Caliskan S, Wygoda S, Hohbach-Hohenfellner K, Dusek J, Urasinski T, Arbeiter K, Neuhaus T, Gellermann J, Drozdz D, Fischbach M, Möller K, Wigger M, Peruzzi L, Mehls O, Schaefer F (2009) Strict blood-pressure control and progression of renal failure in children. N Engl J Med 361:1639–1650

    Article  PubMed  Google Scholar 

  24. Weaver DJ Jr, Kimball TR, Koury PR, Mitsnefes MM (2009) Cardiac output and associated left ventricular hypertrophy in pediatric chronic kidney disease. Pediatr Nephrol 24:565–570

    Article  PubMed  Google Scholar 

  25. Potter EV, Lipschultz SA, Abidh S, Poon-King T, Earle DP (1982) Twelve to seventeen-year follow up of patients with acute poststreptococcal glomerulonephritis in Trinidad. N Engl J Med 307:725–729

    Article  CAS  PubMed  Google Scholar 

  26. Baldwin DS, Gluck MC, Schacht RG, Gallo G (1974) The long-term course of poststreptococcal glomerulonephritis. Ann Intern Med 80:342–358

    CAS  PubMed  Google Scholar 

  27. Popovic-Rolovic M (1973) Serum C3 level in acute glomerulonephritis and postnephritic children. Arch Dis Child 48:622–626

    Article  CAS  PubMed  Google Scholar 

  28. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, Narkiewicz K, Ruilope L, Rynkiewicz A, Schmieder RE, Boudier HA, Zanchetti A, Vahanian A, Camm J, De Caterina R, Dean V, Dickstein K, Filippatos G, Funck-Brentano C, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL, Erdine S, Kiowski W, Agabiti-Rosei E, Ambrosioni E, Lindholm LH, Viigimaa M, Adamopoulos S, Agabiti-Rosei E, Ambrosioni E, Bertomeu V, Clement D, Erdine S, Farsang C, Gaita D, Lip G, Mallion JM, Manolis AJ, Nilsson PM, O’Brien E, Ponikowski P, Redon J, Ruschitzka F, Tamargo J, van Zwieten P, Waeber B, Williams B; Management of Arterial Hypertension of the European Society of Hypertension; European Society of Cardiology (2007) 2007 Guidelines for the Management of Arterial Hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 25:1105–1187

    Article  CAS  PubMed  Google Scholar 

  29. Wang MC, Tsai WC, Chen JY, Huang JJ (2005) Stepwise increase in arterial stiffness corresponding with the stages of chronic kidney disease. Am J Kidney Dis 45:494–501

    Article  PubMed  Google Scholar 

  30. Stancanelli B, Malatino LS, Malaponte G, Noto P, Giuffrè E, Caruso A, Gagliano C, Zoccolo AM, Puccia G, Castellino P (2007) Pulse pressure is an independent predictor of aortic stiffness in patients with mild to moderate chronic kidney disease. Kidney Blood Press Res 30:283–288

    Article  PubMed  Google Scholar 

  31. Kim DH, Kim J, Kim JM, Lee AY (2008) Increased brachial-ankle pulse wave velocity is independently associated with risk of cerebral ischemia small vessel disease in elderly hypertensive patients. Clin Neurol Neurosurg 110:599–604

    Article  PubMed  Google Scholar 

  32. Huang WH, Chen KH, Hsu CW, Chen YC, Hung CC, Huang JY, Lin JL, Yang CW (2008) Residual renal function—one of the factors associated with arterial stiffness in peritoneal dialysis patients. Blood Purif 26:133–137

    Article  PubMed  Google Scholar 

  33. O’Rourke MF, Safar ME (2005) Relationship between aortic stiffening and microvascular disease in brain and kidney: cause and logic of therapy. Hypertension 46:200–204

    Article  PubMed  Google Scholar 

  34. Anderson S, Brenner BM (1995) The role of nephron mass and of intraglomerular pressures in initiation and progression of experimental hypertensive-renal disorders. In: Laragh JH, Brenner BM (eds) Hypertension: pathophysiology, diagnosis and management, 2nd edn. New York, Raven Press, pp 1553–1568

    Google Scholar 

  35. Ohya Y, Iseki K, Iseki C, Miyagi T, Kinjo K, Takishita S (2006) Increased pulse wave velocity is associated with low creatinine clearance and proteinuria in a screened cohort. Am J Kidney Dis 47:790–797

    Article  CAS  PubMed  Google Scholar 

  36. Matsuda N, Takei T, Fujiu A, Ogawa T, Nitta K (2009) Arterial stiffness in patients with non-diabetic chronic kidney disease. J Atheroscler Thromb 16:57–62

    CAS  PubMed  Google Scholar 

  37. Munakata M, Miura Y, Yoshinaga K; J-TOPP study group (2009) Higher brachial-ankle pulse wave velocity as an independent risk factor for further microalbuminuria in patients with essential hypertension: the J-TOPP study. J Hypertens 27:1466–1471

    Article  Google Scholar 

  38. Bircan Z, Tugay S, Usluer H (2005) Poststreptococcal glomerulonephritis with pulmonary edema and microscopic hematuria. Pediatr Nephrol 20:1204

    Article  PubMed  Google Scholar 

  39. Chiu CY, Huang YC, Wong KS, Hsia SH, Lin CJ, Lin TY (2004) Poststreptococcal glomerulonephritis with pulmonary edema presenting as respiratory distress. Pediatr Nephrol 19:1237–1240

    Article  PubMed  Google Scholar 

  40. Fujinaga S, Ohtomo Y, Umino D, Mochizuki H, Takemoto M, Shimizu T, Yamashiro Y, Kaneko K (2007) Pulmonary edema in a boy with biopsy-proven poststreptococcal glomerulonephritis without urinary abnormalities. Pediatr Nephrol 22:154–155

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Nephrology, Chang Gung Children’s Hospital, Lin-Kou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan

    Mei-Ching Yu

  2. Institute of Microbiology, Immunology and Molecular Medicine, Tzu-Chi University, Hualien, Taiwan

    Mei-Shiuan Yu

  3. Department of Pediatrics, Changhua Christian Hospital, Changhua, Taiwan

    Meng-Kung Yu

  4. Division of Nephrology, Yee Zen General Hospital and Asia Renal Care, Taiwan Branch, Taoyuan, Taiwan

    Fan Lee

  5. Department of Nephrology, Chang Gung Memorial Hospital, Lin-Kou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan

    Wen-Hung Huang

  6. Department of Pediatric Nephrology, Chang Gung Children’s Hospital, Chang Gung University College of Medicine, 5, Fu-Shin Street, Kwei-Shan 333, Taoyuan, Taiwan

    Mei-Ching Yu

Authors
  1. Mei-Ching Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mei-Shiuan Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Meng-Kung Yu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fan Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wen-Hung Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mei-Ching Yu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yu, MC., Yu, MS., Yu, MK. et al. Acute reversible changes of brachial-ankle pulse wave velocity in children with acute poststreptococcal glomerulonephritis. Pediatr Nephrol 26, 233–239 (2011). https://doi.org/10.1007/s00467-010-1590-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-010-1590-2

Keywords

Search

Navigation