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Updated: Jun 7, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Mediterranean Diet Pattern: Potential Impact on the Different Altered Pathways Related to Cardiovascular Risk in
Jordi Rovira1,2, María José Ramirez-Bajo1,2, Elisenda Bañon-Maneus1,2
1Laboratori Experimental de Nefrologia i Trasplantament (LENIT), Institut d'Investigacions Biomètiques August Pi i Sunyer (IDIBAPS), 08027 Barcelona, Spain.
Insights
Cardiovascular disease (CVD) in chronic kidney disease (CKD) is linked to altered serum metabolites and proteins. The Mediterranean diet may help prevent CVD in CKD patients by targeting these pathways.
Area of Science:
- Biochemistry
- Proteomics
- Metabolomics
Background:
- Cardiovascular disease (CVD) is the leading cause of mortality in patients with chronic kidney disease (CKD).
- The Mediterranean diet shows potential in reducing CVD risk through improved endothelial function, inflammation, lipid profile, and blood pressure.
- Integrating metabolomic and proteomic analyses can elucidate uremia-induced CVD pathways in CKD, identifying those modifiable by diet.
Purpose of the Study:
- To investigate the serum metabolomic and proteomic profiles in advanced chronic kidney disease (aCKD).
- To identify specific pathways and biomarkers associated with CVD risk in aCKD patients.
- To explore potential dietary interventions, like the Mediterranean diet, for CVD prevention in CKD.
Main Methods:
- Serum samples from 19 aCKD patients and 27 healthy volunteers underwent metabolomic and proteomic analysis.
- Metabolites were quantified using four distinct methods; proteins were analyzed after depleting seven abundant serum proteins.
- Integrative analysis utilized MetaboAnalyst 4.0 and STRING 11.0 for pathway and biomarker identification.
Main Results:
- 135 metabolites and 75 proteins were differentially expressed in aCKD patients compared to controls.
- Pathway analysis revealed significant alterations in innate immune system pathways (complement, coagulation, neutrophil degranulation) and disrupted linoleic acid and cholesterol metabolism.
- Key altered metabolites and proteins included glutathione peroxidase 3, carnitine, homocitrulline, 3-methylhistidine, and various amino acids.
Conclusions:
- Significant dysregulation of serum metabolome and proteome exists in aCKD, linked to endothelial dysfunction and CVD pathways.
- These findings highlight potential therapeutic targets for CVD in CKD.
- Dietary interventions, such as the Mediterranean diet, may offer a beneficial strategy for CVD prevention in CKD patients.
Background:
Cardiovascular disease (CVD) remains the most common cause of mortality in chronic kidney disease (CKD) patients. Several studies suggest that the Mediterranean diet reduces the risk of CVD due to its influence on endothelial function, inflammation, lipid profile, and blood pressure. Integrating metabolomic and proteomic analyses of CKD could provide insights into the pathways involved in uremia-induced CVD and those pathways modifiable by the Mediterranean diet.
Methods:
We performed metabolomic and proteomic analyses on serum samples from 19 patients with advanced CKD (aCKD) and 27 healthy volunteers. The metabolites were quantified using four different approaches, based on their properties. Proteomic analysis was performed after depletion of seven abundant serum proteins (Albumin, IgG, antitrypsin, IgA, transferrin, haptoglobin, and fibrinogen). Integrative analysis was performed using MetaboAnalyst 4.0 and STRING 11.0 software to identify the dysregulated pathways and biomarkers.
Results:
A total of 135 metabolites and 75 proteins were differentially expressed in aCKD patients, compared to the controls. Pathway enrichment analysis showed significant alterations in the innate immune system pathways, including complement, coagulation, and neutrophil degranulation, along with disrupted linoleic acid and cholesterol metabolism. Additionally, certain key metabolites and proteins were altered in aCKD patients, such as glutathione peroxidase 3, carnitine, homocitrulline, 3-methylhistidine, and several amino acids and derivatives.
Conclusions:
Our findings reveal significant dysregulation of the serum metabolome and proteome in aCKD, particularly in those pathways associated with endothelial dysfunction and CVD. These results suggest that CVD prevention in CKD may benefit from a multifaceted approach, including dietary interventions such as the Mediterranean diet.
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