[Endothelial dysfunction and apoptosis at early stage of chronic kidney disease].

AIM: To study changes in apoptosis and endothelial function in patients with chronic kidney disease (CKD) stage I-IIIb (CKDsI-IIIb).

MATERIAL AND

METHODS

A complex of biochemical, enzyme immunoassay and device investigations was used to examine 128 patients with CKDsI-IIIb.

RESULTS

In CKD stage I reduction of endothelium-dependent vasodilation (EDV) was detected in 34% patients, in stage II -- in 52 %, in stage IIIa -- y 52 %, in stage IIIb - in 70%. An EDV decrease was associated with glomerular filtration rate (GFR), a homocysteine level and hemodynamic factors. Elevation of endothelin-1 (ET-1) level was seen in CKDsI in 41 %, in CKDsII - in 54 %, in CKDsIIIa - in 70 %, in stage IIIb - in 83% patients. A negative correlation was observed between the level of ET-1 and GFR and positive - with diurnal proteinuria. A significant rise of annexin A5 concentration versus normal was detected as early as in CKDsI (1,14 +/- 0,68 ng/ml). In CKDsII annexin A5 was 2,61 +/- 0,75 ng/ml, in CKDsIIIa - 3,75 +/- 0,93 ng/ml and in CKDsIIIb - 5,16 +/- 1.01 ng/ml. Negative correlations were found between annexin A5 level and GFR, a maximal growth of volumetric blood flow rate in skin vessels in the acetylcholine test, positive correlations with systolic blood pressure, body mass index.

CONCLUSION

The levels of ET-1 and annexin A5 are factors having an independent impact on EDV in patients with CKDsI-II.