Variations in Circulating Active MMP-9 Levels During Renal Replacement Therapy
Elena Rodríguez-Sánchez1, José Alberto Navarro-García1, Jennifer Aceves-Ripoll1
1Cardiorenal Translational Laboratory, Institute of Research i+12 (imas12), Hospital Universitario 12 de Octubre, 28041, Madrid, Spain.
Abstract:
Renal replacement therapy (RRT) is complicated by a chronic state of inflammation and a high mortality risk. However, different RRT modalities can have a selective impact on markers of inflammation and oxidative stress. We evaluated the levels of active matrix metalloproteinase (MMP)-9 in patients undergoing two types of dialysis (high-flux dialysis (HFD) and on-line hemodiafiltration (OL-HDF)) and in kidney transplantation (KT) recipients. Active MMP-9 was measured by zymography and ELISA before (pre-) and after (post-) one dialysis session, and at baseline and follow-up (7 and 14 days, and 1, 3, 6, and 12 months) after KT. Active MMP-9 decreased post-dialysis only in HFD patients, while the levels in OL-HDF patients were already lower before dialysis. Active MMP-9 increased at 7 and 14 days post-KT and was restored to baseline levels three months post-KT, coinciding with an improvement in renal function and plasma creatinine. Active MMP-9 correlated with pulse pressure as an indicator of arterial stiffness both in dialysis patients and KT recipients. In conclusion, active MMP-9 is better controlled in OL-HDF than in HFD and is restored to baseline levels along with stabilization of renal parameters after KT. Active MMP-9 might act as a biomarker of arterial stiffness in RRT.
Insights
Active matrix metalloproteinase-9 (MMP-9) levels differ across renal replacement therapies. On-line hemodiafiltration better controls MMP-9 than high-flux dialysis, and levels normalize after kidney transplantation.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Inflammation Research
Background:
- Renal replacement therapy (RRT) is associated with chronic inflammation and high mortality.
- Different RRT modalities may selectively influence inflammation and oxidative stress markers.
Purpose of the Study:
- To evaluate active matrix metalloproteinase (MMP)-9 levels in patients undergoing high-flux dialysis (HFD), on-line hemodiafiltration (OL-HDF), and kidney transplantation (KT).
- To assess the impact of RRT modalities and KT on active MMP-9 levels and its correlation with arterial stiffness.
Main Methods:
- Active MMP-9 was quantified using zymography and ELISA.
- Measurements were taken before and after dialysis sessions and at multiple time points post-kidney transplantation.
- Pulse pressure was used as an indicator of arterial stiffness.
Main Results:
- Active MMP-9 decreased post-dialysis in HFD but was lower pre-dialysis in OL-HDF.
- Post-kidney transplantation, active MMP-9 increased initially and normalized by three months, correlating with improved renal function.
- Active MMP-9 correlated with pulse pressure in both dialysis patients and KT recipients.
Conclusions:
- On-line hemodiafiltration demonstrates superior control of active MMP-9 compared to high-flux dialysis.
- Active MMP-9 levels normalize post-kidney transplantation with renal function stabilization.
- Active MMP-9 may serve as a biomarker for arterial stiffness in patients undergoing RRT.
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