The relationship between circulating endothelial microparticles and arterial stiffness and atherosclerosis in children with chronic kidney disease

Background. Endothelial dysfunction is an important factor in the pathogenesis of atherosclerosis, and endothelial microparticles (EMPs) are considered as markers of endothelial dysfunction. In this study, we aimed to examine the relationship between EMPs and arterial stiffness and atherosclerosis i...

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Published in:	Nephrology, dialysis, transplantation Vol. 24; no. 8; pp. 2511 - 2518
Main Authors:	Dursun, Ismail, Poyrazoglu, Hakan M, Gunduz, Zubeyde, Ulger, Harun, Yýkýlmaz, Ali, Dusunsel, Ruhan, Patýroglu, Turkan, Gurgoze, Metin
Format:	Journal Article
Language:	English
Published:	Oxford Oxford University Press 01-08-2009 Oxford Publishing Limited (England)
Subjects:	Adolescent Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy arterial stiffness atherosclerosis Atherosclerosis - physiopathology Biological and medical sciences Blood Pressure Carotid Arteries - diagnostic imaging Carotid Arteries - pathology Case-Control Studies Child children chronic renal failure Cross-Sectional Studies Emergency and intensive care: renal failure. Dialysis management endothelial microparticles Endothelium, Vascular - metabolism Endothelium, Vascular - pathology Female Flow Cytometry Humans Intensive care medicine Kidney Failure, Chronic - blood Kidney Failure, Chronic - pathology Kidney Failure, Chronic - therapy Kidneys Male Medical sciences Nephrology. Urinary tract diseases Peritoneal Dialysis Renal Dialysis Tumors of the urinary system Tunica Media - diagnostic imaging Tunica Media - pathology Ultrasonography Umbilical Veins - cytology Umbilical Veins - metabolism Uremia - blood Uremia - pathology Uremia - therapy Vascular Resistance arterial stiffness atherosclerosis endothelial microparticles children chronic renal failure Human Kidney disease Urinary system disease Hemodialysis Cardiovascular disease Vascular disease Extrarenal dialysis Atherosclerosis Renal failure Stiffness Child
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Summary:	Background. Endothelial dysfunction is an important factor in the pathogenesis of atherosclerosis, and endothelial microparticles (EMPs) are considered as markers of endothelial dysfunction. In this study, we aimed to examine the relationship between EMPs and arterial stiffness and atherosclerosis in children with chronic kidney disease (CKD). Methods. This cross-sectional study included 37 dialysis patients (12 haemodialysis, 25 peritoneal dialysis), 33 pre-dialysis patients and 18 healthy controls. Both in vivo and in vitro (HUVECs) evaluations were used for the study. Circulating EMPs were measured by flow cytometry. The carotid artery intima–media thickness (cIMT) and pulse wave velocity (PWV) were measured by using high-resolution ultrasound. Study groups were compared for circulating EMP, cIMT and PWV. The relationship between EMPs and arterial stiffness and atherosclerosis was evaluated. Results. The levels of PWV, cIMT, CD144 + EMP and CD146 + EMP in the dialysis group were significantly higher than those in the pre-dialysis and control groups (P < 0.05). Additionally, the levels of cIMT, CD144 + EMP and CD146 + EMP in the pre-dialysis group were significantly higher than those in the control group (P < 0.05). In all CKD patients, the CD144 + EMP was significantly positively associated with blood pressures, age, known duration of disease, CRP and PTH, and was significantly negatively associated with haemoglobin, GFR and albumin. The CD146 + EMP was significantly positively associated with blood pressures, age and CRP. In a multiple linear regression analysis, in the CKD group, cIMT was independently related to mean blood pressure and dialysis duration. PWV was independently related to the CD144 + EMP and mean blood pressure. Conclusion. Our results suggest that endothelial damage starts in the early stage of CKD, that the endothelial dysfunction becomes overt with the increase of cardiovascular risk factors and that EMPs may be a reliable marker of the subclinical atherosclerosis and arterial stiffness.
Bibliography:	ArticleID:gfp066 ark:/67375/HXZ-ZNRB5PMB-L istex:D8B1F624E5D7F7F06B9146FD4D578DD2A186C7F1 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0931-0509 1460-2385
DOI:	10.1093/ndt/gfp066