eNOS Glu298Asp Polymorphism and Endothelial Dysfunction in Patients with and without End-stage Renal Disease

Arteriovenous fistula (AVF) is the “lifeline” for patients with end-stage renal disease (ESRD) undergoing hemodialysis. AVF maturation failure is a poorly understood process, one of the contributors being endothelial dysfunction due to oxidative stress. Monoamine oxidases (MAOs) A and B were recently identified as novel sources of vascular oxidative stress. The aim of the present study was to assess the contribution of MAOs to the endothelial dysfunction in patients with ESDR with indication of hemodialysis. Fragments of brachial artery collaterals were harvested from ESRD patients during the surgical procedure aimed at creating the vascular access in the cubital fossa. The effect of increasing concentrations (10, 30, 100 μmol/L) of the irreversible MAO-A inhibitor, clorgyline, and MAO-B inhibitor, selegiline, on endothelial-dependent relaxation (EDR) in response to cumulative doses of acetylcholine was studied in isolated phenylephrine-preconstricted vascular rings. Hydrogen peroxide (H2O2) production was assessed using ferrous oxidation xylenol orange assay. We showed that incubation of brachial rings with MAO inhibitors significantly improved EDR and attenuated H2O2 generation in patients with ESRD. MAO-related oxidative stress might contribute to the primary dysfunction/non-maturation of the AVF and MAO inhibitors could improve maturation and long-term patency of the vascular access in dialysis patients.

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Mechanisms of Endothelial Dysfunction in Resistance Arteries from Patients with End-Stage Renal Disease

PLoS ONE ◽

10.1371/journal.pone.0036056 ◽

2012 ◽

Vol 7 (4) ◽

pp. e36056 ◽

Cited By ~ 27

Author(s):

Leanid Luksha ◽

Peter Stenvinkel ◽

Folke Hammarqvist ◽

Juan Jesús Carrero ◽

Sandra T. Davidge ◽

...

Keyword(s):

Endothelial Dysfunction ◽

Renal Disease ◽

End Stage Renal Disease ◽

Resistance Arteries ◽

Stage Renal Disease ◽

End Stage

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Associations of Macro- and Microvascular Endothelial Dysfunction With Subclinical Ventricular Dysfunction in End-Stage Renal Disease

Hypertension ◽

10.1161/hypertensionaha.116.07489 ◽

2016 ◽

Vol 68 (4) ◽

pp. 913-920 ◽

Cited By ~ 14

Author(s):

Ruth F. Dubin ◽

Isabella Guajardo ◽

Amrita Ayer ◽

Claire Mills ◽

Catherine Donovan ◽

...

Keyword(s):

Endothelial Dysfunction ◽

Renal Disease ◽

End Stage Renal Disease ◽

Ventricular Dysfunction ◽

Microvascular Endothelial ◽

Stage Renal Disease ◽

End Stage

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Raynaud’s Phenomenon and Endothelial Dysfunction in End-Stage Renal Disease Patients Treated with Hemodialysis

Kidney & Blood Pressure Research ◽

10.1159/000081059 ◽

2005 ◽

Vol 28 (1) ◽

pp. 27-31 ◽

Cited By ~ 6

Author(s):

Aneta Czupryniak ◽

Anna Kałużyńska ◽

Michał Nowicki ◽

Bogusław Więcek ◽

Edward Bald ◽

...

Keyword(s):

Endothelial Dysfunction ◽

Renal Disease ◽

End Stage Renal Disease ◽

Raynaud’S Phenomenon ◽

Raynaud's Phenomenon ◽

Stage Renal Disease ◽

End Stage

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The effect of hemodialys on endothelial dysfunction in patients with end-stage renal disease

Clinical Medicine (Russian Journal) ◽

10.18821/0023-2149-2017-95-10-935-939 ◽

2017 ◽

Vol 95 (10) ◽

pp. 935-939

Author(s):

Aleksandr B. Susla ◽

I. R. Mysula ◽

A. I. Gozhenko

Keyword(s):

Endothelial Dysfunction ◽

Renal Disease ◽

End Stage Renal Disease ◽

Platelet Rich Plasma ◽

Circulating Endothelial Cells ◽

Chronic Glomerulonephritis ◽

Nitrate Anion ◽

Sh Groups ◽

Stage Renal Disease ◽

End Stage

Purpose. To study the effect of a single hemodialysis (HD) session on the endothelial structure and function by analyzing the contents of nitric oxide (NO) stable metabolites and circulating endothelial cells (CECs) number, and to establish the interrelation between the oxidative stress (OS) marker malondialdehyde (MDA) and endothelial dysfunction indices in patients with end-stage renal disease (ESRD). Material and methods. The study included 20 chronic HD patients (9 men aged 41,0±3,0 years; HD duration, (40,4±4,8) months). Patients with chronic glomerulonephritis (65%) dominated. Plasma content of MDA, the activity of superoxide dismutase (SOD) and catalase (CT) in erythrocytes, blood content of SH-groups were measured before and after the HD session by standard methods. Plasma content of nitrite-( NO2-) and nitrate anion (NO3-) was estimated by the spectrophotometric method, and CEC amount in platelet-rich plasma ss described by Hladovec J. et al., 1978 in our modification. Results. After the HD session NO2- content decreased by 18,4% (p<0,001), NO3- by 13,4% (p=0,007), while CEC number did not significantly change (p=0,478). Due to HD the content of MDA increased by 10,5% (p=0,007), the activity of SOD, CT increased by 8,9% (p=0,005) and 16,2% (p=0,016) respectively, and the concentration of SH-groups decreased by 20,8% (p<0,001). Significant correlation between the content of MDA and NO2- (Rs=-0,56, p=0,010), CECs amount (Rs=0,52, p=0,018) was established; the CEC number was in turn related to the level of NO2- (Rs=-0,58, p=0,007). Conclusions. The HD session is associated with the development of OS, lack of NO and possibly endothelial damage which confirms practicability of endothelial protection, in particular modulation of the L-arginine-NO system, during HD session in patients with ESRD.

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Abstract 145: Endothelial Dysfunction: A Key Determinant of Ventricular Dysfunction in End-Stage Renal Disease

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.35.suppl_1.145 ◽

2015 ◽

Vol 35 (suppl_1) ◽

Author(s):

Ruth Dubin ◽

Isabella Guajardo ◽

Claire Mills ◽

Catherine Donovan ◽

Lauren Beussink-Nelson ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Endothelial Dysfunction ◽

Renal Disease ◽

Endothelial Function ◽

End Stage Renal Disease ◽

Global Longitudinal Strain ◽

Left Ventricular ◽

High Rate ◽

Stage Renal Disease ◽

End Stage

Objectives: Mechanisms underlying the high rate of cardiovascular mortality in patients with end-stage renal disease (ESRD) are poorly understood. We sought to determine whether endothelial dysfunction is associated with left ventricular (LV) and right ventricular (RV) dysfunction in ESRD. Methods: Stable patients with ESRD (n=75) underwent measurement of: (1) flow-mediated dilation (FMD), using upper arm brachial occlusion, and (2) cardiac mechanics, using speckle-tracking echocardiography (STE). Microvascular function was measured as the velocity time integral (VTI) of hyperemic blood flow following cuff deflation. Eight participants returned for repeat endothelial testing at 1-week intervals. Results: The mean±SD age was 54±11 years, 38% were diabetic, and 17% were on peritoneal dialysis. FMD median (IQR) was 4.7% (2.7-6.9%) and VTI was 0.62m (0.45-0.72m). After adjustment for age, gender, diabetes and systolic blood pressure, lower VTI was associated with worse RV longitudinal free wall strain (β=6.3% per 1m VTI; 95% CI [1.8, 11]; p=0.007). In patients with ejection fraction ≥50%, lower FMD was associated with worse LV global longitudinal strain (β=0.36% per 1% FMD; 95% CI [0.11,0.61]; p=0.005). Mean absolute differences at one week for FMD and VTI were 1.8% and 0.19m. Conclusions: In a diverse cohort of patients on hemo- or peritoneal dialysis, worse endothelial function was associated with LV and RV mechanics after adjustment for clinical factors. Repeatability of FMD and VTI were in accordance with current guidelines. Future studies are needed to investigate whether therapies that improve endothelial function could improve cardiac function in ESRD.

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