Study of atherogenic indices in nephrotic syndrome

Abstract

Nephrotic Syndrome (NS) describes the clinical state characterized by the presence of proteinuria, hypoalbuminemia and edema. Dyslipidemia is a contributory factor in the progression of initial glomerular injury in NS. The aim of the present study was to estimate the Atherogenic indices: Cardiac Risk Ratio (CRR), Atherogenic Coefficient (AC), Atherogenic Index of Plasma (AIP) in adult NS patients. The present study was conducted on 99 normal healthy adult subjects & 315 adult NS patients amongst which 105 controlled NS patients with primary NS, 105 managed NS patients which were on remission & 105 uncontrolled NS patients with complications. CRR AIP & AC were found to be increased in all three types of NS patients. CRR in controlled NS was increased significantly (7.16 ± 2.05), (P<0.000) when compared with normal healthy subjects (3.71 ± .95). There was significant decrease in CRR during remission (5.91±1.25), (p<0.000) when compared with controlled NS. In uncontrolled NS, further significant increase was observed in CRR (14.51±3.94), (p<0.000) when compared with controlled NS. AIP in controlled NS was increased significantly (0.96 ± .322), (P<0.000) when compared with normal healthy subjects (-0.21 ± 0.35). There was significant decrease in AIP during remission (0.291±0.205), (p<0.000) when compared with controlled NS. In uncontrolled NS, further significant increase was observed in AIP (1.511 ±0.336), (p<0.000) when compared with controlled NS. AC in controlled NS was increased significantly (6.16 ±2.05), (P<0.000) when compared with normal healthy subjects (2.71± 95). There was significant decrease in AC during remission (4.91±1.25), (p<0.000) when compared with controlled NS. In uncontrolled NS, further significant increase was observed in AC (13.51±3.945), (p<0.000) when compared with controlled NS. The study results support the hypothesis that impairment in the endothelial functions constitute a link between Nephrotic Syndrome & atherosclerosis etc. These disturbances were dependent on the degree of proteinuria and decrease in serum albumin concentration. The patients with severe clinical course of Nephrotic Syndrome were at high risk of accelerated atherogenesis.