| 19925466 |
Gorgulu N, Yelken B, Caliskan Y, Elitok A, Cimen AO, Yazici H, Oflaz H, Golcuk E, Ekmekci A, Turkmen A, Yildiz A, Sever MS: Endothelial dysfunction in hemodialysis patients with failed renal transplants. Clin Transplant. 2009 Nov 18.
Background: Endothelial dysfunction (ED) is a common precursor and denominator of cardiovascular events including development of atherosclerosis. In this cross-sectional study, we aimed to investigate ED, measured by coronary flow reserve (CFR) in hemodialysis (nHD) patients who were never transplanted and patients with failed renal transplants restarting hemodialysis (fTx-HD). Methods: Forty nHD (24 males, mean age 39 +/- 9 yr) and 43 fTx-HD patients (27 males, mean age 36 +/- 9 yr) were included in the study. Clinical and biochemical parameters, including high-sensitive C-reactive protein (hs-CRP) levels were determined. Also, CFR measurements were used to evaluate ED. Results: There were no significant differences regarding age, gender, smoking status, systolic and diastolic blood pressure levels, mean duration of HD treatment as well as Kt/V ((urea)) values between the two groups. Time spent on dialysis in the nHD group and dialysis duration following failure of renal allograft in the fTx-HD group were similar. Serum creatinine, hemoglobin, hematocrit, calcium and phosphorus levels were similar between the two groups as well. When compared to nHD group, serum total cholesterol (139 +/- 3 vs. 154 +/- 3 mg/dL, p = 0.045), serum albumin (3.8 +/- 0.3 g/dL vs. 4.1 +/- 0.2 g/dL, p < 0.0001) and CFR (1.60 +/- 0.2 vs. 1.75 +/- 0.3, p = 0.028) levels were significantly lower, while serum hs-CRP levels (11 +/- 15 mg/L vs. 3 +/- 4 mg/L, p = 0.001) were significantly higher in the fTx-HD group. Serum hs-CRP negatively correlated (r = -0254, p = 0.021), while serum albumin positively correlated (r = 0402, p = 0.001) with CFR values. Conclusion: ED is more prominent in fTx-HD than the nHD patients. Inflammation, caused by failed renal allograft can be responsible for this abnormality. |
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