Cardiovascular Disease, Chronic Kidney Disease
Conditions
Keywords
chronic kidney disease, cardiovascular disease, nitric oxide, homocysteine, asymmetric dimethylarginine, methylation
Brief summary
Chronic kidney disease (CKD) and end-stage renal disease are highly prevalent in Taiwan. Cardiovascular disease (CVD) is the most common cause of death in children with CKD. Nitric oxide (NO) deficiency links CKD and CVD. Asymmetric dimethylarginine (ADMA), a NO synthase inhibitor, its level is increased in kidney disease and cardiovascular disease and serves as a methylation biomarker. In addition to ADMA, uremic environment, hyperhomocysteinemia (Hcy) and oxidative stress may affect DNA methylation. S-adenosylmethionine (SAM) is an important human methyl donor. S-adenosylhomocysteine (SAH) is demethylated product. Methylenetetrahydrofolate reductase (MTHFR), a folate metabolism enzyme can regulate methylation pathway. The investigators intend to examine whether ADMA, SAM/SAH ratio, Hcy, and MTHFR gene methylation can serve as biosignature to predict CVD in children with CKD children.
Interventions
OTHERMethylation biosignature
Methylation biosignature, CKD staging, assessment of cardiovascular function, and traditional/uremia-related risk factors will be performed.
Sponsors
Chang Gung Memorial Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
3 Years to 18 Years
Healthy volunteers
Yes
Inclusion criteria
* chronic kidney disease stage 1-4 * Volunteer
Exclusion criteria
* pregnancy * renal transplant * congenital heart disease * not able to be adherent/complaint with study procedure * not volunteer
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| change from baseline level of asymmetric dimethylarginine (ADMA) at 24 months | from the time of enrollment, every 6 months, up to 24 months | at the time of enrollment, 6 months, 12 months, 18 months, and 24 months |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| change from the baseline level of hyperhomocysteinemia (Hcy) at 24 months | from the time of enrollment, every 6 months, up to 24 months | at the time of enrollment, 6 months, 12 months, 18 months, 24 months |
| change from the baseline health-related quality of life at 24 months | from the time of enrollment, every 6 months, up to 24 months | EQ-5D-Y instrument will be employed at the time of enrollment, 6 months, 12 months, 18 months, 24 months |
| change from the baseline ratio of SAM/SAH (S-adenosylmethionine /S-adenosylhomocysteine ) at 24 months | from the time of enrollment, every 6 months, up to 24 months | at the time of enrollment, 6 months, 12 months, 18 months, 24 months |
Countries
Taiwan
Outcome results
None listed