A cross-sectional study measuring vanadium and chromium levels in paediatric patients with CKD
Journal Articles
Overview
Research
Identity
Additional Document Info
View All
Overview
abstract
ObjectivesAlthough 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.DesignAncillary cross-sectional study to a prospective, longitudinal, randomised controlled trial.SettingChildren’s Hospital of Western Ontario, London Health Sciences Centre, London, Ontario, Canada.Participants36 children and adolescents 4–18 years of age with CKD.Interventions1–6 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 measuresPrimary outcomes: plasma Cr and V. Secondary outcomes: age, season, CysC, CysC eGFR, and Cr and V levels in environmental water.ResultsThe median (IQR) eGFR was 51 mL/min/1.73 m2(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.ConclusionsOur 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 m2.Trial registration numberNCT02126293; HC#172241.
