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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Evaluation of renal vascular lesions using circulating endothelial cells in patients with lupus nephritis
1Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, PR China.
Insights
Elevated circulating endothelial cells (CECs) indicate renal vascular lesions in lupus nephritis (LN). CEC counts may help monitor disease activity and treatment effectiveness in LN patients.
Area of Science:
- Nephrology
- Immunology
- Vascular Biology
Background:
- Renal vascular lesions (VLS) in lupus nephritis (LN) diagnosis relies heavily on invasive biopsy.
- A need exists for non-invasive biomarkers for dynamic clinical evaluation of VLS in LN.
Purpose of the Study:
- To investigate the correlation between circulating endothelial cell (CEC) counts and the presence of renal VLS in patients with LN.
- To explore CECs as potential surrogate biomarkers for assessing LN vasculopathy.
Main Methods:
- CEC enumeration from peripheral blood using anti-CD-146 immunomagnetic beads.
- Comparison of CEC counts between LN patients with and without VLS, and healthy controls.
- Assessment of renal function parameters (serum creatinine, BUN, urine protein) and blood pressure.
Main Results:
- CEC numbers were significantly higher in LN patients with VLS compared to those without VLS and controls.
- CEC counts positively correlated with serum creatinine and mean blood pressure.
- CEC levels were elevated in LN patients with thrombotic microangiopathy (TMA) within the VLS group.
Conclusions:
- CEC numeration shows promise as a non-invasive marker for vasculopathy in LN.
- Dynamic monitoring of CEC counts can aid in assessing disease severity, activity, and therapeutic response in LN.
Objective:
Currently the detection of renal vascular lesions (VLS) mainly depends on biopsy examination, and lacks surrogate biomarkers for clinical dynamic evaluation. The aim of this study is to find the correlation between numbers of circulating endothelial cells (CECs) and renal VLS in lupus nephritis (LN).
Methods:
Thirty LN patients with VLS and 30 LN patients without VLS were recruited. Thirty age- and sex-matched healthy volunteers served as controls. CECs were isolated from peripheral blood with anti-CD-146-coated immunomagnetic Dynabeads and were counted under microscopy. Parameters of renal involvement, including blood urea nitrogen, serum creatinine, 24 h urine protein excretion and quantitative urine sedimentation were also measured.
Results:
The number of CECs showed no difference between LN patients without VLS and controls. In patients with VLS, the number of CECs was significantly higher than those without VLS (P < 0.01). A strong positive correlation was found between CECs and serum creatinine (r = 0.503, P < 0.01) and mean blood pressure (r = 0.423, P < 0.05). In all LN patients with VLS, CEC number of the patients with thrombotic microangiopathy (TMA) significantly increased compared with those without TMA (P < 0.01).
Conclusion:
Numeration of CECs may serve as a potential and useful marker for vasculopathy in LN. Dynamic observations of CEC number can be used not only to provide evidence for monitoring disease severity and disease activity, but also to determine therapy efficacy in LN patients.
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