Factors associated with Endothelial Dysfunction in Hemodialysis Patients.
- Author:
Jung Hwa RYU
1
;
Mina YU
;
Dong Ryeol RYU
;
Seung Jung KIM
;
Kyu Bok CHOI
;
Kyun Il YOON
;
Duk Hee KANG
;
Wook Bum PYUN
;
Gil Ja SHIN
Author Information
1. Division of Nephrology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea. dhkang@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
Vascular endothelium-dependent relaxation;
C-reactive protein;
Inflammation;
Hemodialysis
- MeSH:
C-Reactive Protein;
Cardiovascular Diseases;
Humans;
Inflammation;
Muscle, Smooth;
Myocardial Ischemia;
Nutritional Status;
Prognosis;
Reaction Time;
Renal Dialysis;
Vasodilation
- From:Korean Journal of Nephrology
2008;27(2):195-204
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Endothelial dysfunction is an event in the atherosclerotic process usually considered reversible at its early stage. Early detection, therefor, may improve the prognosis in the cardiovascular disease. The aim of this study was to investigate the vascular function in hemodialysis (HD) patients and to explore its relation to other various parameters with a specific emphasis on systemic inflammatory reaction (SIR), nutritional status and the presence of ischemic heart disease (IHD). METHODS: Flow-mediated endothelium-dependent vasodilatation (FMD) was measured, using Doppler sonogram, in 37 stable HD patients, 11 healthy people and 24 hypertensive controls. Nitroglycerine- induced endothelium-independent vasodilatation (EIV) and peak reaction time (PT) of each FMD and EIV were also measured. RESULTS: FMD in HD patients was decreased compared to healthy group whereas it was comparable in HD patients and hypertensive control. EIV in HD patients was significantly decreased compared to healthy and hypertensive controls. PT of each FMD and EIV was significantly delayed in HD patients. Each FMD and EIV showed a negative correlation with serum hsCRP level, but no significant correlations of FMD with other parameters were noted. Both FMD and EIV were further decreased in HD patients with IHD than non-IHD group. CONCLUSION: Our study confirmed a characteristic pattern of vascular dysfunction in HD patients: the impaired endothelial and smooth muscle function with a delayed reaction time. Importantly, SIR was one of the important factors determining vascular dysfunction in HD patients. Further studies will be necessary to define the causative role of SIR on endothelial dysfunction and the effect of inflammation- modulating therapy.
