A cross-sectional study measuring vanadium and chromium levels in paediatric patients with CKD.

Autor:	Filler G; Department of Paediatrics, Division of Paediatric Nephrology, Children's Hospital, London, Ontario, Canada.; Lilibeth Caberto Kidney Clinical Research Unit, London Health Sciences Centre, London, Ontario, Canada.; Department of Medicine, Division of Nephrology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.; Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada., Kobrzynski M; Department of Paediatrics, Division of Paediatric Nephrology, Children's Hospital, London, Ontario, Canada.; Lilibeth Caberto Kidney Clinical Research Unit, London Health Sciences Centre, London, Ontario, Canada., Sidhu HK; Department of Paediatrics, Division of Paediatric Nephrology, Children's Hospital, London, Ontario, Canada., Belostotsky V; Department of Paediatrics, Division of Paediatric Nephrology, McMaster Children's Hospital, Hamilton, Ontario, Canada., Huang SS; Department of Paediatrics, Division of Paediatric Nephrology, Children's Hospital, London, Ontario, Canada.; Lilibeth Caberto Kidney Clinical Research Unit, London Health Sciences Centre, London, Ontario, Canada.; Department of Medicine, Division of Nephrology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada., McIntyre C; Department of Paediatrics, Division of Paediatric Nephrology, Children's Hospital, London, Ontario, Canada.; Lilibeth Caberto Kidney Clinical Research Unit, London Health Sciences Centre, London, Ontario, Canada.; Department of Medicine, Division of Nephrology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada., Yang L; Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2017 Jun 06; Vol. 7 (5), pp. e014821. Date of Electronic Publication: 2017 Jun 06.
DOI:	10.1136/bmjopen-2016-014821
Abstrakt:	Objectives: Although many secondary effects of high levels of vanadium (V) and chromium (Cr) overlap with symptoms seen in paediatric patients with chronic kidney disease (CKD), their plasma V and Cr levels are understudied. Design: Ancillary cross-sectional study to a prospective, longitudinal, randomised controlled trial. Setting: Children's Hospital of Western Ontario, London Health Sciences Centre, London, Ontario, Canada. Participants: 36 children and adolescents 4-18 years of age with CKD. Interventions: 1-6 trace element measurements per patient. Cystatin C (CysC) estimated glomerular filtration rate (eGFR) was calculated using the Filler formula. Plasma V and Cr levels were measured using high-resolution sector field inductively coupled mass spectrometry. Anthropomorphic data and blood parameters were collected from our electronic chart programme. Water Cr and V data were obtained from the Ontario Water (Stream) Quality Monitoring Network. Primary and Secondary Outcome Measures: Primary outcomes: plasma Cr and V. Secondary Outcomes: age, season, CysC, CysC eGFR, and Cr and V levels in environmental water. Results: The median (IQR) eGFR was 51 mL/min/1.73 m 2 (35, 75). The median V level was 0.12 µg/L (0.09, 0.18), which was significantly greater than the 97.5th percentile of the reference interval of 0.088 µg/L; 32 patients had at least one set of V levels above the published reference interval. The median Cr level was 0.43 µg/L (0.36, 0.54), which was also significantly greater than the established reference interval; 34 had at least one set of Cr levels above the published reference interval. V and Cr levels were moderately correlated. Only some patients had high environmental exposure. Conclusions: Our study suggests that paediatric patients with CKD have elevated plasma levels of V and Cr. This may be the result of both environmental exposure and a low eGFR. It may be necessary to monitor V and Cr levels in patients with an eGFR <30 mL/min/1.73 m 2 . Trial Registration Number: NCT02126293; HC#172241. Competing Interests: Competing interests: None declared. (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
Databáze:	MEDLINE
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