ESPN 50th Annual Meeting

ESPN 2017


 
Vascular Endothelial Dysfunction in Renal Replacement Therapy Modalities
ALEV YILMAZ 1 ZEYNEP YURUK YILDIRIM 1 ASUMAN GEDIKBASI 2 BAGDAGUL AKSU 3 AYSE AGBAS 3 CEMILE PEHLIVANOGLU 1 OZDE NISA TURKKAN 1 SEVINC EMRE 1

1- ISTANBUL UNIVERSITY ISTANBUL FACULTY OF MEDICINE PEDIATRIC NEPHROLOGY DEPARTMENT
2- BAKIRKOY DR. SADI KONUK TRAINING AND RESEARCH HOSPITAL BIOCHEMISTRY DEPARTMENT
3- HASEKI TRAINING AND RESEARCH HOSPITAL PEDIATRIC NEPHROLOGY DEPARTMENT
 
Introduction:

Vascular endothelial dysfunction (VED) is an important cause of cardiovascular morbidity and mortality in end-stage renal disease (ESRD). Endothelin-1 (ET-1) and nitric oxide (NO) are vasoactive substances which was affected in ESRD. The aim of the study was to compare serum ET-1 and NO levels in renal transplant recipients (RTx group) and patients receiving hemodialysis (HD group), online-hemodiafiltration (HDF group), peritoneal dialysis (PD group).

Material and methods:

Fourty-one patients and 25 healthy children were enrolled in the study. Serum ET-1 and NO levels were measured by ELISA in all patients and controls. Intradialytic symptoms and ambulatory blood pressure monitoring was evaluated in HD and HDF groups. 

Results:

Rtx group had the lowest level of serum ET-1 and NO although the difference did not reach statistical significance. Median serum ET-1 level were not significantly different between the HD and HDF group (589.944ng/l and 593.717ng/l; respectively, p>0.05). Also, these levels were not different between the PD, RTx and HD groups (546.343ng/l, 343.555 and 589.944ng/l; respectively, p>0.05). Median ET-1 level were significantly lower in RTx group than the HDF group (343.555ng/l and 593.717ng/l; respectively, p=0.025).  The median serum NO level was not different between the HD, HDF, PD and RTx groups (590.237µmol/l, 563.084µmol/l, 582.433µmol/l, 438.268µmol/l; respectively, p>0.05).

There was no difference between the HD and HDF groups in terms of hypertension, hyperparathyroidism, anemia, metabolic acidosis, hyperlipidemia, inter-dialytic weight gains and Kt/v (p>0.05). When each patient groups were compared with the control group separately NO and ET-1 levels were higher in patient groups (p=0.0001). Median NO level was 56.212µmol/l, ET-1 level was 31.827ng/l in the control group.

Conclusions:

Our results suggest that ESRD causes VED. No difference between ESRD treatment modalities (HD, HDF, PD) in terms of ET-1 and NO indicates that VED continues in all treatment modalities. Renal transplantation is superior to other treatment modalities.