Early markers of cardiovascular risk in chronic kidney disease. (14th November 2014)

• Record Type: Journal Article
• Authors: Lai, Silvia; Dimko, Mira; Galani, Alessandro; Coppola, Bettina; Innico, Georgie; Frassetti, Nicla; Mazzei, Egidio Domenico; Mariotti, Amalia
• Is Part Of: Renal failure. Volume 37:Number 2(2015)
• Page Start: 254
• Page End: 261
• Publication Date: 2014-11-14
• Subjects: Brachial artery flow-mediated dilation -- cardiac troponin T -- carotid intima-media thickness -- chronic kidney disease -- endothelial dysfunction -- N-terminal pro-brain natriuretic peptide; Chronic renal failure -- Periodicals; Acute renal failure -- Periodicals; Uremia -- Periodicals; 616.614005
• DOI: 10.3109/0886022X.2014.982489
• Languages: English
• ISSNs: 0886-022X

Abstract

Abstract: Background : Patients with chronic kidney disease (CKD) present a markedly increased cardiovascular (CV) morbidity and mortality since the early stages and have a high prevalence of accelerated atherosclerosis, inflammation and endothelial dysfunction. Nontraditional cardiovascular risk factors and serum cardiac biomarkers would contribute to explain this increased morbidity. Aim : The aim is to investigate the relation among serum cardiac biomarkers (N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT), nontraditional cardiovascular risk factors (serum uric acid, homocysteine), inflammatory indexes (C-reactive protein (CRP) serum ferritin, fibrinogen) and noninvasive predictors of atherosclerosis (carotid intima-media thickness (cIMT), brachial artery flow mediated dilation (baFMD), and left ventricular mass index (LVMI)) in CKD patients. Materials and methods : In 50 patients with CKD in stage 2/3 kidney disease outcomes quality initiative (KDOQI) and 18 age- and sex-matched healthy controls, the following parameters were measured: cardiac markers (cTnT and NT-proBNP), renal function, inflammatory markers (CRP, serum ferritin and fibrinogen), serum uric acid and homocysteine. We have also evaluated LVMIs, cIMT and baFMD. Results : In our study, we showed an increase of NT-proBNP and the serum cTnT, of serum uric acid and homocysteine with a positive correlation with the increase of cIMT and LVMI and reduced baFMD compared with the controls. Conclusions : Serum cardiac biomarkers and nontraditional cardiovascular risk factors increase already in the stage 2/3 KDOQI contributing to explain the high cardiovascular morbidity and mortality of these patients. The NT-proBNP seems to have a rise earlier compared with serum cTnT; however, both seemed to be a useful clinical biomarker for evaluating noninvasive predictors of atherosclerosis in CKD patients.