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2017 ; 12
(5
): e0178171
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Preliminary study of hypoxia-related cardiovascular mediator-markers in patients
with end-stage renal disease with and without diabetes and the effects of
haemodialysis
#MMPMID28542479
Treweeke A
; Hall J
; Lambie S
; Leslie SJ
; Megson IL
; MacRury SM
PLoS One
2017[]; 12
(5
): e0178171
PMID28542479
show ga
BACKGROUND: Evidence points to activation of pro-inflammatory and pro-thrombotic
stimuli during the haemodialysis process in end-stage renal disease (ESRD) with
potential to predispose to cardiovascular events. Diabetes is associated with a
higher incidence of cardiovascular disease in haemodialysis patients. We tested
the hypothesis that a range of mediators and markers that modulate cardiovascular
risk are elevated in haemodialysis patients with diabetes compared to those
without. METHODS: Men and women with diabetes (n = 6) and without diabetes (n =
6) aged 18-90 years receiving haemodialysis were recruited. Blood samples were
collected and analysed pre- and post-haemodialysis sessions for
(platelet-monocyte conjugates (PMC), oxidised LDL (Ox-LDL), endothelin 1 (ET-1)
and vascular endothelial growth factor (VEGF-A). RESULTS: PMC levels
significantly increased after haemodialysis in both groups (diabetes p = 0.047;
non-diabetes p = 0.005). Baseline VEGF-A was significantly higher in people with
diabetes (p = 0.009) and post-dialysis levels were significantly reduced in both
groups (P = 0.002). Ox-LDL and CRP concentrations were not significantly
different between groups nor affected in either group post-dialysis. Similarly,
ET-1 concentrations were comparable in all patients at baseline, with no change
post-dialysis in either group. CONCLUSIONS: In this pilot study, we have
confirmed that circulating PMCs are increased following dialysis irrespective of
diabetes status. This is likely to be a mechanistic process and offers a
potential explanation for high rates of vascular events associated with
haemodialysis. The higher VEGF-A concentrations between patients with and without
diabetes is a previously unreported finding in diabetic ESRD. Further research is
merited to establish whether VEGF-A is a marker or mediator (or both) of
cardiovascular risk in haemodialysis.