Reactivity of microcirculation skin vessels during the distant cold influence and concentration of endotelin-1 in chronic kidney disease

The system endothelial dysfunction is the universal pathogenetic link of atherosclerosis and chronic kidney disease. The hemodynamic disturbances concerned with changed of vegetative regulation the tonus of arterioles may promote the development of endothelial dysfunction at chronic kidney disease (CKD). The aim of our study was to investigate the features of reflective vasomotor reactions of skin vessels during the distant cold influence at patients with CKD I and II studies. It was investigated 34 healthy men (mean age 39.0±1.9 years) and 167 patients with CKD (mean age 41.6±1.9 years). The glomerular filtration rate was calculated at MDRD formula. Cold probe was lead all of the patients. Qas at the time of cold stimulus decreased at 35.3 % at CKD I st., at 42.3 % at CKD II st. and 19.3 % at healthy men. The decreased of Qas at patients with CKD I and II st. remained at 3 minutes after ending the probe, but at healthy men it normalized immediately after the probe. Concentration of endotelin-1 in blood plasma has made 0.239±0,055 fmol/ml, at CKD I stages 0.335±0,068 fmol/l, p <0.05, CKD II stages to 0.424±0.040 fmol/l, p<0.01, distinctions between groups are authentic, p<0.01. Interrelations between level of endotelin-1 and speed of a glomerular filtration rate (Rs=0.249, p<0.05), and also a daily proteinuria (Rs=0.379, p<0.003) and Qas % during time cold probe (Rs =-0.391, p<0.003), and also time of restoration of background value Qas (Rs =-0.327, p<0.003) have been revealed. Authors consider, that dysfunction of vegetative nervous system at early stage of CKD is realized by synthesis activation endotelin-1 in reply to strengthening of sympathetic influences.Our results testify to hypersympaticotonia at early stage of CKD.

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