Evaluation of Endothelial (dys)Function, Left Ventricular Structure and Function in Patients with Chronic Kidney...

Area of Science:

• Nephrology
• Cardiology
• Biochemistry

Background:

• Endothelial dysfunction is a key factor in atherosclerosis and cardiovascular issues in chronic kidney disease (CKD).
• Asymmetric dimethylarginine (ADMA), an endothelial nitric oxide synthase (eNOS) inhibitor, serves as a marker for endothelial dysfunction.

Purpose of the Study:

• To evaluate serum ADMA and eNOS levels, alongside left ventricular structure and function in CKD patients.
• To assess the effect of different dialyzer types on serum ADMA and eNOS concentrations post-hemodialysis (HD).

Main Methods:

• Blood samples were collected from 35 predialysis CKD patients, 40 HD patients, and 15 healthy controls.
• HD patients were grouped by dialyzer membrane (polynephron or cellulose); plasma ADMA and eNOS were measured.
• Echocardiography assessed left ventricular structure and function; biochemical parameters were also evaluated.

Main Results:

• CKD patients exhibited significantly higher serum ADMA and lower eNOS compared to healthy subjects.
• Both dialyzer types reduced serum ADMA post-HD without significant difference between them.
• Stage V CKD patients with the highest ADMA showed reduced left ventricle ejection fraction and increased left ventricle mass and diameter.

Conclusions:

• The findings support the presence of endothelial dysfunction in CKD patients.
• Elevated ADMA correlates with adverse left ventricular changes, suggesting its role in cardiovascular complications in CKD.