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Endothelial dysfunction in patients with kidney failure and vascular risk factors: acute effects of hemodialysis.
Ital Heart J 2004; 5(5):371-7IH

Abstract

BACKGROUND

Patients with kidney failure present endothelial dysfunction, which was shown to be partly corrected by hemodialysis. No data exist on the effects of hemodialysis on endothelial dysfunction in kidney failure patients with associated vascular risk factors. The aim of this study was to evaluate the acute effects of hemodialysis on endothelial dysfunction in patients with kidney failure and associated vascular risk factors and to assess the role of endothelium-toxic substances.

METHODS

We assessed endothelial dysfunction in 13 patients with chronic renal failure and other vascular risk factors before and after hemodialysis and in 13 healthy controls and simultaneously measured nitric oxide (NO) synthesis and activity. Endothelial dysfunction was studied using an echographic method as flow-mediated dilation (FMD) of the brachial artery; plasma NO2- and NO3-, cyclic guanosine-5-monophosphate (cGMP), plasma homocysteine levels and low molecular mass-advanced glycation end-products (LMM-AGEs) were simultaneously measured.

RESULTS

As compared with healthy controls, patients with renal failure showed a reduced FMD (2.89 +/- 1.43 vs. 7.81 +/- 1.54%, p < 0.01) which was not corrected by dialysis (after dialysis 2.40 +/- 1.65%, p = NS vs. pre). Plasma NO2- and NO3- were normal or slightly increased and remained unchanged after dialysis. Plasma cGMP levels were reduced and remained unchanged after dialysis. Homocysteine and LMM-AGE plasma levels were raised and, although significantly reduced by dialysis, remained higher than in controls.

CONCLUSIONS

Patients with kidney failure and associated vascular risk factors show an endothelial dysfunction related to defective NO activity, which is not corrected by hemodialysis despite the reduction, though not to normal, in homocysteine and LMM-AGE levels. Endothelial dysfunction may contribute to the progression of atherosclerosis in patients with kidney failure and vascular risk factors.

Authors+Show Affiliations

Division of General Medicine, Civic Hospital, Cortona (AR), Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15185901

Citation

Migliacci, Rino, et al. "Endothelial Dysfunction in Patients With Kidney Failure and Vascular Risk Factors: Acute Effects of Hemodialysis." Italian Heart Journal : Official Journal of the Italian Federation of Cardiology, vol. 5, no. 5, 2004, pp. 371-7.
Migliacci R, Falcinelli F, Imperiali P, et al. Endothelial dysfunction in patients with kidney failure and vascular risk factors: acute effects of hemodialysis. Ital Heart J. 2004;5(5):371-7.
Migliacci, R., Falcinelli, F., Imperiali, P., Floridi, A., Nenci, G. G., & Gresele, P. (2004). Endothelial dysfunction in patients with kidney failure and vascular risk factors: acute effects of hemodialysis. Italian Heart Journal : Official Journal of the Italian Federation of Cardiology, 5(5), pp. 371-7.
Migliacci R, et al. Endothelial Dysfunction in Patients With Kidney Failure and Vascular Risk Factors: Acute Effects of Hemodialysis. Ital Heart J. 2004;5(5):371-7. PubMed PMID: 15185901.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endothelial dysfunction in patients with kidney failure and vascular risk factors: acute effects of hemodialysis. AU - Migliacci,Rino, AU - Falcinelli,Francesca, AU - Imperiali,Patrizio, AU - Floridi,Ardesio, AU - Nenci,Giuseppe G, AU - Gresele,Paolo, PY - 2004/6/10/pubmed PY - 2004/11/9/medline PY - 2004/6/10/entrez SP - 371 EP - 7 JF - Italian heart journal : official journal of the Italian Federation of Cardiology JO - Ital Heart J VL - 5 IS - 5 N2 - BACKGROUND: Patients with kidney failure present endothelial dysfunction, which was shown to be partly corrected by hemodialysis. No data exist on the effects of hemodialysis on endothelial dysfunction in kidney failure patients with associated vascular risk factors. The aim of this study was to evaluate the acute effects of hemodialysis on endothelial dysfunction in patients with kidney failure and associated vascular risk factors and to assess the role of endothelium-toxic substances. METHODS: We assessed endothelial dysfunction in 13 patients with chronic renal failure and other vascular risk factors before and after hemodialysis and in 13 healthy controls and simultaneously measured nitric oxide (NO) synthesis and activity. Endothelial dysfunction was studied using an echographic method as flow-mediated dilation (FMD) of the brachial artery; plasma NO2- and NO3-, cyclic guanosine-5-monophosphate (cGMP), plasma homocysteine levels and low molecular mass-advanced glycation end-products (LMM-AGEs) were simultaneously measured. RESULTS: As compared with healthy controls, patients with renal failure showed a reduced FMD (2.89 +/- 1.43 vs. 7.81 +/- 1.54%, p < 0.01) which was not corrected by dialysis (after dialysis 2.40 +/- 1.65%, p = NS vs. pre). Plasma NO2- and NO3- were normal or slightly increased and remained unchanged after dialysis. Plasma cGMP levels were reduced and remained unchanged after dialysis. Homocysteine and LMM-AGE plasma levels were raised and, although significantly reduced by dialysis, remained higher than in controls. CONCLUSIONS: Patients with kidney failure and associated vascular risk factors show an endothelial dysfunction related to defective NO activity, which is not corrected by hemodialysis despite the reduction, though not to normal, in homocysteine and LMM-AGE levels. Endothelial dysfunction may contribute to the progression of atherosclerosis in patients with kidney failure and vascular risk factors. SN - 1129-471X UR - https://www.unboundmedicine.com/medline/citation/15185901/Endothelial_dysfunction_in_patients_with_kidney_failure_and_vascular_risk_factors:_acute_effects_of_hemodialysis_ L2 - https://medlineplus.gov/kidneyfailure.html DB - PRIME DP - Unbound Medicine ER -