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Tumor necrosis factor gene expression in regular hemodialysis patients
Hemmat E El Haddad, Mohamed A Marie1, Tarek M Samy
1Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
Summary
Patients with end-stage renal disease (ESRD) undergoing hemodialysis show elevated tumor necrosis factor-alfa (TNF-alfa) gene expression and C-reactive protein (CRP) levels, indicating increased cardiovascular disease risk and atherosclerosis. These markers correlate with sub-clinical arterial changes.
Area of Science:
- Nephrology
- Cardiology
- Molecular Biology
Background:
- Cardiovascular disease (CVD) is a major complication in patients with end-stage renal disease (ESRD).
- Uremic arteriopathy contributes significantly to CVD risk in ESRD patients.
- Tumor necrosis factor-alfa (TNF-alfa) and C-reactive protein (CRP) are implicated in inflammation and atherosclerosis.
Purpose of the Study:
- To evaluate TNF-alfa gene expression in ESRD patients on hemodialysis.
- To assess the relationship between TNF-alfa gene expression, CRP, lipid profile, and carotid intima-media thickness (cIMT) as indicators of CVD risk and uremic arteriopathy.
Main Methods:
- Cross-sectional study comparing 51 ESRD patients on hemodialysis with 20 healthy controls.
- Measurements included serum lipid profile, CRP levels, TNF-alfa gene expression (relative quantification - RQ), and carotid intima-media thickness (cIMT) via Doppler ultrasound.
Main Results:
- ESRD patients exhibited significantly higher serum triglycerides, CRP positivity, TNF-alfa gene expression (RQ), and cIMT compared to controls.
- HDL levels were significantly lower in ESRD patients.
- TNF-alfa gene expression (RQ) positively correlated with CRP levels and negatively with cIMT. CRP also showed a negative correlation with age and a positive correlation with HDL.
Conclusions:
- Patients with ESRD on hemodialysis demonstrate increased TNF-alfa gene expression and CRP levels.
- These inflammatory markers are associated with sub-clinical atherosclerosis, as evidenced by increased cIMT.
- Elevated TNF-alfa and CRP contribute to the heightened cardiovascular risk observed in ESRD patients.
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