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Markers of increased atherosclerotic risk in patients with chronic kidney disease: a preliminary study.

ABSTRACT: The prevalence of chronic kidney disease is rising continuously. Cardiovascular disease is among leading causes of death and premature mortality of patients with chronic kidney disease. Even the earliest stages of chronic kidney disease are associated with higher risk of subsequent coronary heart disease. The aim of this study was to determine markers of increased risk of atherosclerosis in CKD.The study group consisted of a total of 80 patients (20 patients with stage I/II CKD, 20 with stage III CKD, 20 stage IV CKD and 20 stage V/dialysis) and 24 healthy volunteers. Levels of proteins (osteoprotegerin, osteopontin, osteocalcin, matrix ?-carboxyglutamic acid protein, fetuin A, MMP-2, MMP-9, TIMP-1, TIMP-2) and biochemical parameters were measured to analyse their influence on atherosclerosis risk in CKD patients. Cardiac echocardiography was performed to assess structural integrity and function, presence of left ventricular hypertrophy and systolic and diastolic function dysfunction.This study shows that the prevalence of ventricular hypertrophy (95.3 %) and diastolic dysfunction (93.2 %) in CKD patients is high. Also E/E' ratio was significantly higher (13.6 ± 4.4, p = 0.001), tricuspid insufficiency (27.3 in CKD I/II vs. 71.4 in CKD V, p = 0.016), contractile dysfunction (33.3 in CKD I/II vs. 78.9 in CKD V, p = 0.040), mitral valve calcification (0 in CKD I/II vs. 28.6 in CKD V, p = 0.044) and aortic valve calcification (0 in CKD I/II vs. 61.9 in CKD V, p = 0.0008) were significantly more frequent in patients with CKD stage V/dialysis than in other groups. Only MMP-2, MMP-2/TIMP-2 ratio and TIMP-1 differed significantly between groups.This study shows high prevalence of ventricular hypertrophy and diastolic dysfunction in CKD patients. Contractile dysfunction, mitral and aortic valve calcification in HD patients were significantly more frequent than in patients with other CKD stages. Significantly increased levels of MMP-2, MMP-2/TIMP-2 ratio and lower TIMP-1 suggests that these factors may be involved in the pathogenesis of atherosclerosis in CKD patients.

SUBMITTER: Gluba-Brzozka A

PROVIDER: S-EPMC4739105 | biostudies-other | 2016 Feb

REPOSITORIES: biostudies-other

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Markers of increased atherosclerotic risk in patients with chronic kidney disease: a preliminary study.

Gluba-Brzózka Anna A Michalska-Kasiczak Marta M Franczyk Beata B Nocuń Marek M Toth Peter P Banach Maciej M Rysz Jacek J

Lipids in health and disease 20160203

<h4>Background</h4>The prevalence of chronic kidney disease is rising continuously. Cardiovascular disease is among leading causes of death and premature mortality of patients with chronic kidney disease. Even the earliest stages of chronic kidney disease are associated with higher risk of subsequent coronary heart disease. The aim of this study was to determine markers of increased risk of atherosclerosis in CKD.<h4>Methods</h4>The study group consisted of a total of 80 patients (20 patients wi ...[more]

PMID: 26843213

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Project description:In Brazil, the incidence and prevalence of CKD are increasing, the prognosis remains poor and the costs of treating the disease are very high. Added to this is the increase in the main risk factors for the development and progression of CKD, such as greater aging of the population, high prevalence of AH, DM, overweight, smoking and others, which suggests the continuation of CKD as a serious problem of public health. This situation requires prevention actions, early diagnosis of the disease and agile action in the face of the functional changes evidenced. Furthermore, there is a need to find ways to prevent the progression of the disease. A disturbing issue in nephrology practice is the observation that a significant number of CKD patients lose renal function asymptomatically. One of the reasons is late diagnosis and referral to dialysis. The main causes are: the fact that CKD is often asymptomatic, difficulty in diagnosis, tendency of doctors not to refer patients adequately, selection of patients with less morbidities to start dialysis, resistance of patients to treatment, deficient structure of the health system and lack of access to treatment. The consequences of late referral are reflected in greater morbidity, mortality, costs and worse quality of life. In this sense, it is important to search for new markers of the disease that allow early diagnosis, monitoring of progression and, eventually, improving response to treatment. Analyzing mechanisms underlying renal failure and identifying unique biomarkers (such as metabolite ratios) have the potential to increase our understanding of CKD and improve disease diagnosis and treatment algorithms. In this sense, this project can represent important progress in CKD proteomics research, based on complex information obtained from proteomics associated with basic medical information. New biomarkers are needed as non-invasive tools to aid the accurate diagnosis of kidney diseases with similar clinical characteristics but different prognosis. This project aims to investigate the proteomics of saliva from chronic kidney disease patients in the search for molecular markers that can be used in both the diagnosis and prognosis of the disease. So, for this, it was necessary to select healthy individuals and chronic kidney disease patients, and collect sociodemographic, behavioral, food consumption, clinical and anthropometric data from these individuals. Next, the mass spectrometry proteomics technique was performed on saliva samples and investigated molecules that could be used as markers of CKD and other associated comorbidities, in addition to evaluating whether any molecule could be indicative of the progression of CKD.

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Markers of increased atherosclerotic risk in patients with chronic kidney disease: a preliminary study.

Publications

Markers of increased atherosclerotic risk in patients with chronic kidney disease: a preliminary study.

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