Endothelial dysfunction in patients on program hemodialysis

Introduction. The authors draw readers’ attention to markers of endothelial dysfunction in chronic kidney disease. Objective – to study changes in endothelial dysfunction indicators in patients undergoing program hemodialysis. Materials and methods. The study included 80 patients. The first group consisted of healthy volunteers in the amount of 40 people. The second group consisted of 40 patients who had been on program hemodialysis for more than one year. The following indicators of endothelial dysfunction were studied: intercellular adhesion molecules (Icam); angiotensin-II; adhesion molecules of the vascular endothelium (Vcam); selectin SL; Superoxide dismutase (Cu / Zn-SOD); dimethylarginine (ADMA); products of deep protein oxidation (AOPP); oxistat; endothelin-1 (1-21); C-reactive protein (CRP), endothelin synthase. Results. The level of serum Cu / Zn-SOD is statistically significantly increased relative to the control values in patients of two groups. The total level of AORP in the blood serum of patients with dialysis is statistically significantly higher than the control value. The minimum value of its level in healthy volunteers was 71.6 μmol/L, the maximum – 98.7 μmol/L. In dialysis patients, 78.6 and 391.0 μmol/L, respectively. A comparative analysis showed a significant increase in the levels of Icam, Vcam, ADMA, C-reactive protein, angiotensin-II in the serum of patients with dialysis relative to the values of the control group. Icam: 98.7 ng/ml – the minimum indicator in the group of healthy volunteers, 386.1 ng/ml – the maximum level in this group; 218.5 ng/ml is the lower level and 944.5 ng/ml is the maximum value in the group of dialysis patients. Vcam: 241.8 ng/ml – the minimum value in healthy volunteers is 941.6 ng/ml – maximum; 731.6 ng/ml is the minimum and 3451.1 ng/ml is the maximum in dialysis patients. Conclusions. The results of our study showed a statistically significant increase in all the studied parameters in the group of patients on program hemodialysis in comparison with healthy volunteers. The hemodialysis procedure causes certain biochemical changes in the patient’s body, which in turn lead to the development of oxidative stress and chronic inflammation.

hemodialysis, endothelial dysfunction, oxidative stress, constant vascular access

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