scholarly journals Sex differences in endothelial function in chronic kidney disease

2020 ◽  
Vol 319 (1) ◽  
pp. F33-F40
Author(s):  
Nicholas T. Kruse ◽  
Zhiying You ◽  
Kerrie Moreau ◽  
Jessica Kendrick ◽  
Diana Jalal
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Sex Differences ◽  
Kidney Disease ◽  
Vascular Function ◽  
Vascular Dysfunction ◽  
Men And Women ◽  
Younger Women ◽  
Younger Men

Vascular dysfunction plays an important role in the etiology of chronic kidney disease (CKD) and is associated with cardiovascular diseases. Sex differences in vascular function are common in clinical and nonclinical populations. However, no data exist in individuals with CKD. The present study tested the hypothesis that sex and/or aging differences exist in vascular function in patients with CKD. Endothelium-dependent dilation (EDD; measured via brachial artery flow-mediated dilation) and endothelium-independent dilation (EID; measured via nitroglycerin-mediated dilation) were assessed. Analyses were adjusted for several variables that could influence vascular function (diabetes, cardiovascular disease, and blood pressure). Women, in general, had higher EDD values than men (6.5 ± 4.9% vs. 4.4 ± 3.4%); however, EID did not differ among these groups. In younger men and women (<55 yr old), EDD and EID were higher ( P < 0.05) than their older (≥55 yr old) counterparts (EDD: 7.0 ± 4.1% vs. 4.4 ± 3.8% and EID: 24.0 ± 9.6% vs. 18.3 ± 9.2%). Additionally, younger women exhibited higher ( P < 0.05) EDD and EID compared with younger men (EDD: 9.5 ± 6.4% vs. 5.1 ± 3.8%, P = 0.01, and EID: 24.0 ± 9.6% vs. 18.3 ± 9.2%). No differences in EDD and EID were present between older men and women with CKD. Diabetes independently predicted lower EID but not EDD in men and women. Blood pressure and cardiovascular disease did not predict EDD or EID. This is the first study to show significant sex differences in vascular function. Moreover, these differences are evident between younger men and women with CKD but are abolished with age. Additional studies are needed to better understand the mechanisms that may underlie sex differences in vascular dysfunction with CKD.

scholarly journals ET-1 as a Sex-Specific Mechanism Impacting Age-Related Changes in Vascular Function

2021 ◽  
Vol 2 ◽  
Author(s):  
Andrew V. Kuczmarski ◽  
Laura M. Welti ◽  
Kerrie L. Moreau ◽  
Megan M. Wenner
Keyword(s):  
Sex Differences ◽  
Vascular Function ◽  
Cardiovascular Health ◽  
Vascular Dysfunction ◽  
Developed Countries ◽  
Therapeutic Interventions ◽  
Vascular Aging ◽  
Cvd Risk ◽  
Men And Women ◽  
Age Related

Aging is a primary risk factor for cardiovascular disease (CVD), which is the leading cause of death in developed countries. Globally, the population of adults over the age of 60 is expected to double by the year 2050. CVD prevalence and mortality rates differ between men and women as they age in part due to sex-specific mechanisms impacting the biological processes of aging. Measures of vascular function offer key insights into cardiovascular health. Changes in vascular function precede changes in CVD prevalence rates in men and women and with aging. A key mechanism underlying these changes in vascular function is the endothelin (ET) system. Studies have demonstrated sex and sex hormone effects on endothelin-1 (ET-1), and its receptors ETA and ETB. However, with aging there is a dysregulation of this system resulting in an imbalance between vasodilation and vasoconstriction. Thus, ET-1 may play a role in the sex differences observed with vascular aging. While most research has been conducted in pre-clinical animal models, we describe more recent translational data in humans showing that the ET system is an important regulator of vascular dysfunction with aging and acts through sex-specific ET receptor mechanisms. In this review, we present translational evidence (cell, tissue, animal, and human) that the ET system is a key mechanism regulating sex-specific changes in vascular function with aging, along with therapeutic interventions to reduce ET-mediated vascular dysfunction associated with aging. More knowledge on the factors responsible for the sex differences with vascular aging allow for optimized therapeutic strategies to attenuate CVD risk in the expanding aging population.

Abstract 16926: The Effects of a Mitochondrial Targeted Ubiquinone (MitoQ) on Vascular Function in Chronic Kidney Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Danielle L Kirkman ◽  
Ninette Shenouda ◽  
Joseph M Stock ◽  
Bryce J Muth ◽  
Nicholas Chouramanis ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Brachial Artery ◽  
Vascular Function ◽  
Vascular Dysfunction ◽  
Aortic Pressure ◽  
Double Blind ◽  
Reflected Waves ◽  
Arterial Hemodynamics ◽  
Artery Flow

Introduction: Aberrant vascular function contributes to the substantially high cardiovascular burden of chronic kidney disease (CKD). Mitochondrial derived oxidative stress is a potential therapeutic target to ameliorate CKD related vascular dysfunction. Hypothesis: We hypothesized that a mitochondrial targeted antioxidant (MitoQ) would improve vascular function in Stage 3-5 CKD patients without overt cardiovascular disease. Methods: In this controlled, double-blind trial, 18 CKD patients (Mean±SEM: Age, 62±3 years; eGFR, 45±3 ml•min•1.73 2 ) were randomized to receive an oral dose of MitoQ (20mg/day; MTQ) or a Placebo (PLB) for 4 weeks. Outcome measures were assessed at week 0 and week 4. Aortic pressure waves were synthesized from brachial artery waveforms acquired by oscillometry and the use of a generalized transfer function. The central pressure waveform was separated into forward and reflected waves using a triangular flow waveform. Conduit artery vascular function was assessed via brachial artery flow mediated dilation (FMD). Results: MitoQ was well tolerated and patient compliance was high (MTQ, 99.6±0.4%; PLB, 97.8±2.2%). Independent of peripheral (Baseline vs. Follow Up: MTQ, 140±6 vs. 137±6 mmHg; PLB, 136±4 vs. 134±6 mmHg; interaction p=0.7) and central (MTQ, 128±5 vs. 123±6 mmHg; PLB, 124±3 vs. 123±5 mmHg; interaction p=0.8) systolic blood pressures, MitoQ maintained forward wave amplitudes (MTQ, 31±3 vs. 29±1 mmHg; PLB, 29±3 vs. 36±3 mmHg; interaction p=0.05) and tended to reduce reflected wave amplitudes (MTQ, 18±2 vs. 16±1 mmHg; PLB, 19±2 vs. 21±2 mmHg; interaction p=0.04). MitoQ administration favored improvements in FMD (MTQ, 2.4±0.3 vs. 4.0±0.9%; PLB, 4.2±1.0 vs. 2.5±1.0%; interaction p=0.04). Conclusions: These results suggest that targeting mitochondrial derived reactive oxygen species holds promise as a potential therapeutic strategy to improve CKD related vascular dysfunction. Whether MitoQ related improvements in arterial hemodynamics are a result of augmented cardiac function or a reduction in vascular resistance warrants future investigation in larger studies.

scholarly journals Circulating argonaute-bound microRNA-126 reports vascular dysfunction & response to treatment in acute & chronic kidney disease

2020 ◽  
Author(s):  
Kathleen M Scullion ◽  
A D Bastiaan Vliegenthart ◽  
Laura Rivoli ◽  
Wilna Oosthuyzen ◽  
Tariq E Farrah ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Vascular Function ◽  
Clinical Decision Making ◽  
Vascular Dysfunction ◽  
Unmet Need ◽  
Post Treatment ◽  
Response To Treatment ◽  
Serum Samples ◽  
Anca Vasculitis

Background: Vascular and kidney dysfunction commonly co-exist. There is an unmet need for biomarkers of vascular health. Circulating microRNAs (miRs) are disease biomarkers; miR-126 is endothelial cell-enriched. We measured circulating miR-126 in rats with nephrotoxic nephritis (NTN) and humans with acute endothelial and renal injury (vasculitis associated with autoantibodies to neutrophil cytoplasm antigens (ANCA)). We then compared these findings to those from patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD), and explored the relationship between miR-126 and markers of vascular dysfunction. Methods: In rats, NTN was induced with nephrotoxic serum. Samples were prospectively collected from 70 patients with ANCA vasculitis (at presentation and once in treatment-induced remission), healthy subjects (n=60), patients with CKD (n=30) and ESRD before and after dialysis (n=15). In humans and rats, miR-126 and miR-122 (liver-specific control) were measured and correlated with vascular function. Results: In NTN rats, miR-126 was selectively reduced. In ANCA vasculitis, pre-treatment circulating miR-126 was reduced compared to health (88-fold reduction, ROC-AUC 0.87 (0.80-0.94)). miR-126 increased 3.4-fold post-treatment but remained lower than in health (~26-fold). There was no change in miR-122. Plasma fractionation demonstrated that argonaute 2-bound miR-126 increased with treatment of ANCA vasculitis. Urinary miR-126 decreased post-treatment. miR-126 did not differ between CKD and health but its concentration significantly correlated with measures of endothelial dysfunction. miR-126 was substantially reduced in ESRD (~350 fold compared to health and CKD). Conclusions: miR-126 may be a marker of vascular inflammation and has the potential to aid in clinical decision-making.

Association of visit-to-visit variability of systolic blood pressure with cardiovascular disease, chronic kidney disease and mortality in patients with hypertension

2020 ◽  
Vol 38 (5) ◽  
pp. 943-953 ◽  
Author(s):  
Eric Yuk Fai Wan ◽  
Esther Yee Tak Yu ◽  
Weng Yee Chin ◽  
Daniel Yee Tak Fong ◽  
Edmond Pui Hang Choi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Systolic Blood Pressure

scholarly journals Endocan level in patients with chronic kidney disease

2021 ◽  
Vol 11-12 (221-222) ◽  
pp. 35-42
Author(s):  
Togzhan Abdikalikova ◽  
◽  
Lyudmila Turgunova ◽  
Botagoz Baidildina ◽  
Zhanar Mursalova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Glomerular Filtration Rate ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Total Cholesterol ◽  
Filtration Rate ◽  
Active Smoking

The relevance of the work is due to the high prevalence of chronic kidney disease (CKD) among the population and high mortality from cardiovascular disease (CVD) in this population. In this connection, it is necessary to search for new biomarkers in order to early identify individuals with cardiovascular risk in patients with CKD. The purpose of this study to assess the endocan level in patients with CKD depending on the glomerular filtration rate (GFR), to study the relationship between the endocan level and other cardiovascular risk factors in patients with CKD. Material and methods. 153 respondents with various stages of CKD were examined. The study included socio-demographic, anthropometric data, blood pressure measurements, cholesterol, high density lipoprotein (HDL), triglycerides (TG), glucose and endocan. Data analysis was performed using the statistical software package SPSS 22. Results and discussion. The respondents in the groups did not differ in such indicators as gender, age, marital status, frequency of active smoking, diabetes, body mass index (BMI). Significant differences were found in the level of education (p=0.04), income (p=0.008), systolic pressure (SBP) (p=0.0001) and diastolic blood pressure (DBP) (p=0.0001). Levels of total cholesterol (cholesterol), (p=0.0001), uric acid (p=0.0001), cystatin C (p=0.0001) and endocan (p=0.0001) also had significant differences depending on GFR. Conclusion. A comparative analysis of the frequency of “traditional” cardiovascular risk factors among patients with various stages of CKD showed the absence of differences in the frequency of active smoking, diabetes mellitus, obesity and the presence of significant differences in blood pressure and total cholesterol (p = 0.0001). Evaluation of the endocan level depending on the stage of CKD showed that with the progression of CKD, the endocan level increases significantly (p = 0.0001), which may indicate the progression of endothelial dysfunction with impaired renal function. Further studies are needed to determine the prognostic value of endocan in the development of cardiovascular events in patients with CKD. Keywords: chronic kidney disease, cardiovascular disease, glomerular filtration rate, biomarkers, endocan.

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