Interrelationship of Multiple Endothelial Dysfunction Biomarkers with Chronic Kidney Disease. (June 2015) - Chen, Jing
Abstract : Background: The interrelationship of endothelial biomarkers and chronic kidney disease (CKD) has not been well studied. Objective: We investigated the association of multiple biomarkers of endothelial dysfunction with the risk and severity of CKD. Method: We measured asymmetric dimethylarginine (ADMA), L-arginine, soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular adhesion molecule-1 (sVCAM-1), soluble E-selectin (sE-selectin), von Willebrand factor (vWF), flow-mediated dilation (FMD), and nitroglycerin-induced dilation (NID) in 201 patients with CKD and 201 controls without CKD. Multivariable analyses were used to examine the interrelationship of endothelial biomarkers with CKD. Result: The multivariable-adjusted medians (interquartile ranges) were 0.54 (0.40, 0.75) in patients with CKD vs. 0.25 (0.22, 0.27) μmol /L in controls without CKD ( p < 0.0001 for group difference) for ADMA; 67.0 (49.6, 86.7) vs. 31.0 (27.7, 34.2) μmol/L ( p < 0.0001) for L-arginine; 230.0 (171.6, 278.6) vs. 223.9 (178.0, 270.6) ng/mL (p = 0.55) for sICAM-1; 981.7 (782.6, 1216.8) vs. 633.2 (507.8, 764.3) ng/mL ( p < 0.0001) for sVCAM-1; 47.9 (35.0, 62.5) vs. 37.0 (28.9, 48.0) ng/mL ( p = 0.01) for sE-selectin; 1320 (1044, 1664) vs. 1083 (756, 1359) mU/mL ( p = 0.008) for vWF; 5.74 (3.29, 8.72) vs. 8.80 (6.50, 11.39)% ( p = 0.01) for FMD; and 15.2 (13.5, 16.9) vs. 19.1 (17.2, 21.0)% ( p = 0.0002) for NID, respectively. In addition, the severity of CKD was positively associated with ADMA, L-arginine, sVCAM-1, sE-selectin, and vWF and inversely associated with FMD and NID. Furthermore, FMD and NID were significantly and inversely correlated with ADMA, L-arginine, sVCAM-1, sE-selectin, and vWF. Conclusion: These data indicate that multiple dysfunctions of the endothelium were present among patients with CKD.