Current data suggest the role of autoimmune reactions in the pathogenesis of cardiovascular complications in CRF patients. Elevated levels of anti-Hsp autoantibodies (anti-Hsp60, anti-Hsp70) have been described in adults with atherosclerotic lesions and cardiovascular events. The aim of the study was to evaluate the levels of anti-Hsp60 and anti-Hsp70 in sera of CRF children. Serum uric acid, lipid profile, erythrocyte sedimentation rate (ESR) and hsCRP were also estimated.
Material and methods: The study was performed on 18 CRF children treated conservatively, divided into 2 subgroups: 8 patients with serum creatinine levels below 265 micromol/l (gr. I) and 10 patients with serum creatinine levels above 265 micromol/l (gr. II). The control group consisted of 13 healthy age-matched subjects with normal kidney function. Anti-Hsp concentrations were evaluated by ELISA, hsCRP levels--by nephelometry.
Results: There were no differences in median values of anti-Hsp60, anti-Hsp70 and total cholesterol (CHOL) between examined groups. Mean hsCRP levels were also comparable. No difference was seen when HDL-C and LDL-C levels in gr. I and control group were compared, whereas TGL concentrations were elevated in gr.I vs. controls (p<0.001). In gr. II HDL-C levels were lower vs. controls (p<0.01), whereas LDL-C and TGL concentrations were higher compared to controls (p<0.001, p<0.0001). LDL-C levels in gr.II were also elevated vs. gr. I (p<0.01). Anti-Hsp70 correlated with serum uric acid (R=-0.82, p=0.04), cholesterol (R=-0.78, p=0.03), CHOL/LDL-C (R=-0.89, p=0.007) and CHOL/TGL (R=-0.75, p=0.03) in gr. I and with ESR after 1h in gr. II (R=0.72, p=0.03). No correlations were found between hsCRP and other parameters.
Conclusions: Preliminary results point at relations between anti-Hsp70, markers of chronic inflammation (ESR) and atherosclerotic risk (uric acid, cholesterol) in CRF children.