ESPN 51th Annual Meeting

ESPN 2018

Thrombomodulin as a new marker of endothelial dysfunction in chronic kidney disease in children
Dorota Drozdz 1 Monika Latka 1 Tomasz Drozdz 2 Krystyna Sztefko 3 Przemko Kwinta 4

1- 1. Department of Pediatric Nephrology and Hypertension, Jagiellonian University Medical College
2- 2. I Department of Cardiology, Interventional Electrocardiology and Hypertension, Jagiellonian University Medical College
3- 3. Dpt. of Clin. Biochemistry, Jagiellonian University Medical College
4- 4. Department of Pediatrics; Jagiellonian University Medical College

 Endothelial dysfunction (ED) and oxidative stress are potential new pathomechanisms of cardiovascular diseases in patients with chronic kidney disease (CKD).The aim of the study was to assess the association between endothelial dysfunction, oxidative stress biomarkers and cardiovascular risk factors in children with CKD. 

Material and methods:

 The serum oxidized LDL (oxLDL), protein carbonyl group, urea, creatinine, cystatin C, thrombomodulin, asymmetric dimethylarginine (ADMA), von Willebrand factor, brain natriuretic peptide (BNP), lipids, high sensitivity C-reactive protein, intercellular adhesion molecule-1 levels and albuminuria were measured. Anthropometric, ambulatory blood pressure (BP) measurements and echocardiography were performed. The studied group consisted of 59 patients aged 0.7-18.6 (mean 11.1) years with stage 1 to 5 CKD.


 Thrombomodulin strongly correlated with creatinine (R=0.666;p<0.001), cystatin C (R=0.738;p<0.001), BNP (R=0.406;p=0.001), ADMA (R=0.353;p=0.01), oxLDL (R=0.340;p=0.009), 24-hour systolic (R=0.345;p=0.011) and mean (R=0.315;p<0.05) BP values, left ventricular mass index (LVMI, R=0.293;p=0.024), and negatively with estimated glomerular filtration rate (R=-0.716;p<0.001). 



In children with CKD, TM strongly depended on kidney function parameters, oxLDL levels and 24-hour systolic and mean BP values. Thrombomodulin seems to be a valuable marker of ED in CKD patients, correlating with CKD stage as well as oxidative stress,  BP values and LVMI.