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2018 ; 2018
(ä): 2670312
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Impaired Gut Epithelial Tight Junction Expression in Hemodialysis Patients
Complicated with Intradialytic Hypotension
#MMPMID29581966
Wu TK
; Lim PS
; Jin JS
; Wu MY
; Chen CH
Biomed Res Int
2018[]; 2018
(ä): 2670312
PMID29581966
show ga
BACKGROUND: There is accumulating evidence pointing to uremia-induced impairment
of the intestinal epithelial barrier structure in advanced chronic kidney disease
(CKD) and hemodialysis (HD) patients. In this study, the impact of intradialytic
hypotension on intestinal barrier integrity is being explored. METHODS:
Immunohistochemical staining was used to detect the expression of 4 types of
tight junction (TJ) proteins such as occludin, zonula occludens-1 (ZO-1),
claudin-1, and claudin-4, in colonic samples of a group of patients receiving
segmental colectomy. Five patients with nondialysis CKD (group 2), 5 HD patients
with intradialytic hypotension (group 3), and 5 non-CKD subjects (group 1) were
examined. RESULTS: Both patients' groups 2 and 3 demonstrated significantly
reduced expression of occludin as compared to group 1 (p < 0.05 and p < 0.01,
resp.). Except for claudin-4, expression of all markers of TJ proteins was
significantly reduced in patients' group 3 as compared to control (p < 0.01). In
addition, decreased expressions of claudin-1 and ZO-1 were also more pronounced
in group 3 when compared to group 2. CONCLUSIONS: This study extends the earlier
finding by demonstrating that dialysis-related hypotension caused even marked
depletion of the key protein constituents of the epithelial TJ.