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.
Study Type
OBSERVATIONAL
Enrollment
69
Methylation biosignature, CKD staging, assessment of cardiovascular function, and traditional/uremia-related risk factors will be performed.
Kaohsiung Chang Gung Memorial Hospital
Kaohsiung City, Taiwan
change from baseline level of asymmetric dimethylarginine (ADMA) at 24 months
at the time of enrollment, 6 months, 12 months, 18 months, and 24 months
Time frame: from the time of enrollment, every 6 months, up to 24 months
change from the baseline health-related quality of life at 24 months
EQ-5D-Y instrument will be employed at the time of enrollment, 6 months, 12 months, 18 months, 24 months
Time frame: from the time of enrollment, every 6 months, up to 24 months
change from the baseline ratio of SAM/SAH (S-adenosylmethionine /S-adenosylhomocysteine ) at 24 months
at the time of enrollment, 6 months, 12 months, 18 months, 24 months
Time frame: from the time of enrollment, every 6 months, up to 24 months
change from the baseline level of hyperhomocysteinemia (Hcy) at 24 months
at the time of enrollment, 6 months, 12 months, 18 months, 24 months
Time frame: from the time of enrollment, every 6 months, up to 24 months
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