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Endothelial dysfunction and oxidative stress in chronic renal failure.
J Nephrol 2004 Jul-Aug; 17(4):512-9JN

Abstract

Uremic patients have an increased incidence of cardiovascular disease (CVD), endothelial dysfunction and oxidative stress that can contribute to cardiovascular (CV) events. To assess the relationship between endothelial dysfunction, oxidative stress and renal failure severity, we studied 40 patients (age 57 +/- 7 yrs, 24 males) affected by chronic kidney disease (CKD) K/DOQI stage 3-5 (serum creatinine (Cr) 5.6 +/- 2.2 mg/dL) on conservative treatment, 20 uremic patients (age 57 +/- 12 yrs, 13 males) on hemodialysis (HD) and 30 healthy controls (56 +/- 12 yrs, 20 males). Before and 2 hr after oral vitamin C (2 g) administration, we measured brachial artery endothelium-dependent vasodilation (flow mediated dilation (FMD)) to reactive hyperemia following 5 min of forearm ischemia and the response to sublingual glyceril trinitrate (GTN). Measurements were made by high-resolution ultrasound and computerized analysis. FMD was lower in CKD patients than in controls (5.3 +/- 2.2 vs. 6.9 +/- 2.8%; p<0.01) and was further reduced in HD patients (3.6 +/- 2.7; p<0.01 vs. CKD patients). Response to GTN was similar in all groups. FMD was related to Cr clearance (r=0.42; p<0.01) in CKD patients, while it related inversely to Kt/V(urea) (r=-0.52; p<0.05) in HD patients. After vitamin C administration, FMD was significantly enhanced in HD (4.7 +/- 2.4%; p<0.01 vs. baseline), but not in CKD patients. Response to GTN was unaffected. However, vitamin C load reduced oxidative stress markers, and increased plasma antioxidant capability in both groups. In conclusion, the reduced endothelium-dependent dilation in the brachial artery of CKD patients is related to renal failure severity. HD patients showed a more marked alteration, which seems to be related, at least in part, to increased oxidative stress.

Authors+Show Affiliations

Department of Internal Medicine, University of Pisa, Pisa, Italy. l.ghiadoni@med.unipi.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

15372412

Citation

Ghiadoni, Lorenzo, et al. "Endothelial Dysfunction and Oxidative Stress in Chronic Renal Failure." Journal of Nephrology, vol. 17, no. 4, 2004, pp. 512-9.
Ghiadoni L, Cupisti A, Huang Y, et al. Endothelial dysfunction and oxidative stress in chronic renal failure. J Nephrol. 2004;17(4):512-9.
Ghiadoni, L., Cupisti, A., Huang, Y., Mattei, P., Cardinal, H., Favilla, S., ... Salvetti, A. (2004). Endothelial dysfunction and oxidative stress in chronic renal failure. Journal of Nephrology, 17(4), pp. 512-9.
Ghiadoni L, et al. Endothelial Dysfunction and Oxidative Stress in Chronic Renal Failure. J Nephrol. 2004;17(4):512-9. PubMed PMID: 15372412.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endothelial dysfunction and oxidative stress in chronic renal failure. AU - Ghiadoni,Lorenzo, AU - Cupisti,Adamasco, AU - Huang,Yale, AU - Mattei,Paola, AU - Cardinal,Heloise, AU - Favilla,Stefania, AU - Rindi,Paolo, AU - Barsotti,Giuliano, AU - Taddei,Stefano, AU - Salvetti,Antonio, PY - 2004/9/17/pubmed PY - 2004/12/24/medline PY - 2004/9/17/entrez SP - 512 EP - 9 JF - Journal of nephrology JO - J. Nephrol. VL - 17 IS - 4 N2 - Uremic patients have an increased incidence of cardiovascular disease (CVD), endothelial dysfunction and oxidative stress that can contribute to cardiovascular (CV) events. To assess the relationship between endothelial dysfunction, oxidative stress and renal failure severity, we studied 40 patients (age 57 +/- 7 yrs, 24 males) affected by chronic kidney disease (CKD) K/DOQI stage 3-5 (serum creatinine (Cr) 5.6 +/- 2.2 mg/dL) on conservative treatment, 20 uremic patients (age 57 +/- 12 yrs, 13 males) on hemodialysis (HD) and 30 healthy controls (56 +/- 12 yrs, 20 males). Before and 2 hr after oral vitamin C (2 g) administration, we measured brachial artery endothelium-dependent vasodilation (flow mediated dilation (FMD)) to reactive hyperemia following 5 min of forearm ischemia and the response to sublingual glyceril trinitrate (GTN). Measurements were made by high-resolution ultrasound and computerized analysis. FMD was lower in CKD patients than in controls (5.3 +/- 2.2 vs. 6.9 +/- 2.8%; p<0.01) and was further reduced in HD patients (3.6 +/- 2.7; p<0.01 vs. CKD patients). Response to GTN was similar in all groups. FMD was related to Cr clearance (r=0.42; p<0.01) in CKD patients, while it related inversely to Kt/V(urea) (r=-0.52; p<0.05) in HD patients. After vitamin C administration, FMD was significantly enhanced in HD (4.7 +/- 2.4%; p<0.01 vs. baseline), but not in CKD patients. Response to GTN was unaffected. However, vitamin C load reduced oxidative stress markers, and increased plasma antioxidant capability in both groups. In conclusion, the reduced endothelium-dependent dilation in the brachial artery of CKD patients is related to renal failure severity. HD patients showed a more marked alteration, which seems to be related, at least in part, to increased oxidative stress. SN - 1121-8428 UR - https://www.unboundmedicine.com/medline/citation/15372412/Endothelial_dysfunction_and_oxidative_stress_in_chronic_renal_failure_ L2 - https://medlineplus.gov/kidneyfailure.html DB - PRIME DP - Unbound Medicine ER -