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Increased endothelin-1 mRNA expression in peripheral blood monocytes of dialysis patients
I Ebihara1, T Nakamura, T Takahashi
1Department of Medicine, Koto Hospital, Tokyo, Japan.
Objective:
To compare plasma endothelin (ET)-1 level and ET-1 mRNA level in peripheral blood monocytes of patients undergoing hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD).
Design:
Endothelin-1 mRNA level in peripheral blood monocytes and plasma ET-1 level were studied in 30 HD patients, 15 CAPD patients, 20 chronic renal failure patients not being dialyzed, and 20 normal healthy controls. Hemodialysis patients were dialyzed three times per week with a bicarbonate dialysate. Different types of dialyzer membrane, viz., cellulose triacetate, cuprophane, polysulfone, polyacrylonitrile, and ethylenevinylalcohol were used in 8, 6, 6, 5, and 5 patients, respectively. Continuous ambulatory peritoneal dialysis patients were dialyzed with four daily exchanges of a 2-L dialysate containing glucose at a concentration of 1.5% to 2.5%.
Results:
Higher levels of ET-1 mRNA in monocytes were observed in HD patients than in CAPD patients (p < 0.01), chronic renal failure patients (p < 0.01), or normal healthy controls (p < 0.001). The level of ET-1 mRNA in monocytes at the end of HD was not significantly higher than that at the start of HD. In addition, these mRNA levels in HD patients showed little difference with different types of dialysis membrane. Plasma ET-1 level in HD patients (10.2 +/- 2.4 pg/mL) was also higher than that in CAPD patients (7.8 +/- 1.6 pg/mL, p < 0.01), in chronic renal failure patients (4.8 +/- 1.2 pg/mL, p < 0.01), or in normal controls (2.6 +/- 0.8 pg/mL, p < 0.001).
Conclusion:
Dialysis itself did not significantly affect ET-1 mRNA levels in monocytes. Chronic stimulation of peripheral blood monocytes may be associated with higher levels of ET-1 mRNA and plasma ET-1 in HD patients than in CAPD patients.
Insights
Patients on hemodialysis (HD) show higher endothelin-1 (ET-1) mRNA and plasma levels compared to continuous ambulatory peritoneal dialysis (CAPD) patients. This suggests chronic monocyte stimulation in HD may elevate ET-1, not dialysis itself.
Area of Science:
- Nephrology
- Molecular Biology
- Cardiovascular Physiology
Background:
- Endothelin-1 (ET-1) is a potent vasoconstrictor implicated in cardiovascular complications of chronic kidney disease.
- Understanding ET-1 regulation in different renal replacement therapies is crucial for patient management.
Purpose of the Study:
- To compare plasma ET-1 levels and ET-1 mRNA expression in peripheral blood monocytes between hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients.
- To investigate the influence of dialysis modality on ET-1 production.
Main Methods:
- Quantification of ET-1 mRNA in monocytes and plasma ET-1 levels.
- Study population included 30 HD patients, 15 CAPD patients, 20 non-dialyzed chronic renal failure patients, and 20 healthy controls.
- HD patients utilized various dialyzer membranes; CAPD patients used standard glucose-based dialysate.
Main Results:
- HD patients exhibited significantly higher monocyte ET-1 mRNA levels compared to CAPD, chronic renal failure, and control groups.
- Plasma ET-1 levels were also significantly elevated in HD patients versus the other groups.
- ET-1 mRNA levels in monocytes were not significantly altered by the duration of a single HD session or by different dialyzer membrane types.
Conclusions:
- The observed higher ET-1 mRNA and plasma levels in HD patients appear related to chronic stimulation of peripheral blood monocytes rather than the dialysis procedure itself.
- These findings differentiate ET-1 regulation between HD and CAPD, potentially impacting cardiovascular risk stratification.