The Impact of Uremic Toxicity Induced Inflammatory Response on the Cardiovascular Burden in Chronic Kidney Disease
Uremic toxin (UT) retention in chronic kidney disease (CKD) affects biological systems. We aimed to identify the associations between UT, inflammatory biomarkers and biomarkers of the uremic cardiovascular response (BUCVR) and their impact on cardiovascular status as well as their roles as predictor...
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| Format: | Article |
| Language: | English |
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MDPI AG
2018-09-01
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| Series: | Toxins |
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| Online Access: | http://www.mdpi.com/2072-6651/10/10/384 |
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| author | Ligia Maria Claro Andrea N. Moreno-Amaral Ana Carolina Gadotti Carla J. Dolenga Lia S. Nakao Marina L.V. Azevedo Lucia de Noronha Marcia Olandoski Thyago P. de Moraes Andréa E. M. Stinghen Roberto Pécoits-Filho |
| author_facet | Ligia Maria Claro Andrea N. Moreno-Amaral Ana Carolina Gadotti Carla J. Dolenga Lia S. Nakao Marina L.V. Azevedo Lucia de Noronha Marcia Olandoski Thyago P. de Moraes Andréa E. M. Stinghen Roberto Pécoits-Filho |
| author_sort | Ligia Maria Claro |
| collection | DOAJ |
| description | Uremic toxin (UT) retention in chronic kidney disease (CKD) affects biological systems. We aimed to identify the associations between UT, inflammatory biomarkers and biomarkers of the uremic cardiovascular response (BUCVR) and their impact on cardiovascular status as well as their roles as predictors of outcome in CKD patients. CKD patients stages 3, 4 and 5 (n = 67) were recruited and UT (indoxyl sulfate/IS, p-cresil sulfate/pCS and indole-3-acetic acid/IAA); inflammatory biomarkers [Interleukin-6 (IL-6), high sensitivity C reactive protein (hsCRP), monocyte chemoattractant protein-1 (MCP-1), soluble vascular adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble Fas (sFas)] and BUCVRs [soluble CD36 (sCD36), soluble receptor for advanced glycation end products (sRAGE), fractalkine] was measured. Patients were followed for 5.2 years and all causes of death was used as the primary outcome. Artery segments collected at the moment of transplantation were used for the immunohistochemistry analysis in a separate cohort. Estimated glomerular filtration rate (eGFR), circulating UT, plasma biomarkers of systemic and vascular inflammation and BUCVR were strongly interrelated. Patients with plaque presented higher signs of UT-induced inflammation and arteries from CKD patients presented higher fractalkine receptor (CX3CR1) tissue expression. Circulating IS (p = 0.03), pCS (p = 0.007), IL-6 (p = 0.026), sFas (p = 0.001), sCD36 (p = 0.01) and fractalkine (p = 0.02) were independent predictors of total mortality risk in CKD patients. Our results reinforce the important role of uremic toxicity in the pathogenesis of cardiovascular disease (CVD) in CKD patients through an inflammatory pathway. |
| first_indexed | 2024-04-11T22:31:13Z |
| format | Article |
| id | doaj.art-866804be73dc4ec7a5de8f67fe3593f1 |
| institution | Directory Open Access Journal |
| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-04-11T22:31:13Z |
| publishDate | 2018-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj.art-866804be73dc4ec7a5de8f67fe3593f12022-12-22T03:59:24ZengMDPI AGToxins2072-66512018-09-01101038410.3390/toxins10100384toxins10100384The Impact of Uremic Toxicity Induced Inflammatory Response on the Cardiovascular Burden in Chronic Kidney DiseaseLigia Maria Claro0Andrea N. Moreno-Amaral1Ana Carolina Gadotti2Carla J. Dolenga3Lia S. Nakao4Marina L.V. Azevedo5Lucia de Noronha6Marcia Olandoski7Thyago P. de Moraes8Andréa E. M. Stinghen9Roberto Pécoits-Filho10Graduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, BrazilGraduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, BrazilGraduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, BrazilBasic Pathology Department, Universidade Federal do Paraná, Curitiba, PR 80050-540, BrazilBasic Pathology Department, Universidade Federal do Paraná, Curitiba, PR 80050-540, BrazilGraduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, BrazilGraduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, BrazilGraduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, BrazilGraduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, BrazilBasic Pathology Department, Universidade Federal do Paraná, Curitiba, PR 80050-540, BrazilGraduate Program in Health Sciences, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, BrazilUremic toxin (UT) retention in chronic kidney disease (CKD) affects biological systems. We aimed to identify the associations between UT, inflammatory biomarkers and biomarkers of the uremic cardiovascular response (BUCVR) and their impact on cardiovascular status as well as their roles as predictors of outcome in CKD patients. CKD patients stages 3, 4 and 5 (n = 67) were recruited and UT (indoxyl sulfate/IS, p-cresil sulfate/pCS and indole-3-acetic acid/IAA); inflammatory biomarkers [Interleukin-6 (IL-6), high sensitivity C reactive protein (hsCRP), monocyte chemoattractant protein-1 (MCP-1), soluble vascular adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble Fas (sFas)] and BUCVRs [soluble CD36 (sCD36), soluble receptor for advanced glycation end products (sRAGE), fractalkine] was measured. Patients were followed for 5.2 years and all causes of death was used as the primary outcome. Artery segments collected at the moment of transplantation were used for the immunohistochemistry analysis in a separate cohort. Estimated glomerular filtration rate (eGFR), circulating UT, plasma biomarkers of systemic and vascular inflammation and BUCVR were strongly interrelated. Patients with plaque presented higher signs of UT-induced inflammation and arteries from CKD patients presented higher fractalkine receptor (CX3CR1) tissue expression. Circulating IS (p = 0.03), pCS (p = 0.007), IL-6 (p = 0.026), sFas (p = 0.001), sCD36 (p = 0.01) and fractalkine (p = 0.02) were independent predictors of total mortality risk in CKD patients. Our results reinforce the important role of uremic toxicity in the pathogenesis of cardiovascular disease (CVD) in CKD patients through an inflammatory pathway.http://www.mdpi.com/2072-6651/10/10/384uremic toxinsinflammatory biomarkerssCD36sRAGEfractalkine (CX3CL1)fractalkine receptor (CX3CR1) |
| spellingShingle | Ligia Maria Claro Andrea N. Moreno-Amaral Ana Carolina Gadotti Carla J. Dolenga Lia S. Nakao Marina L.V. Azevedo Lucia de Noronha Marcia Olandoski Thyago P. de Moraes Andréa E. M. Stinghen Roberto Pécoits-Filho The Impact of Uremic Toxicity Induced Inflammatory Response on the Cardiovascular Burden in Chronic Kidney Disease Toxins uremic toxins inflammatory biomarkers sCD36 sRAGE fractalkine (CX3CL1) fractalkine receptor (CX3CR1) |
| title | The Impact of Uremic Toxicity Induced Inflammatory Response on the Cardiovascular Burden in Chronic Kidney Disease |
| title_full | The Impact of Uremic Toxicity Induced Inflammatory Response on the Cardiovascular Burden in Chronic Kidney Disease |
| title_fullStr | The Impact of Uremic Toxicity Induced Inflammatory Response on the Cardiovascular Burden in Chronic Kidney Disease |
| title_full_unstemmed | The Impact of Uremic Toxicity Induced Inflammatory Response on the Cardiovascular Burden in Chronic Kidney Disease |
| title_short | The Impact of Uremic Toxicity Induced Inflammatory Response on the Cardiovascular Burden in Chronic Kidney Disease |
| title_sort | impact of uremic toxicity induced inflammatory response on the cardiovascular burden in chronic kidney disease |
| topic | uremic toxins inflammatory biomarkers sCD36 sRAGE fractalkine (CX3CL1) fractalkine receptor (CX3CR1) |
| url | http://www.mdpi.com/2072-6651/10/10/384 |
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