Asymmetric dimethylarginine and angiopoietin-like protein-2 are independent predictors of cardiovascular risk in pre-dialysis non-diabetic chronic kidney disease patients
- 1 July 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in International Urology and Nephrology
- Vol. 52 (7), 1321-1328
- https://doi.org/10.1007/s11255-020-02484-0
Abstract
Background Chronic kidney disease (CKD) is associated with increased cardiovascular (CVD) morbidity and mortality. Hence, this study was carried out to assess the biomarkers of endothelial dysfunction and inflammation as predictors of CVD risk in Indian patients with CKD. Methods In this case control study, we recruited 43 patients with CKD and 43 healthy control volunteers. Circulating levels of endothelial dysfunction markers [asymmetric dimethylarginine (ADMA), angiopoietin-like protein-2 (ANGPTL2), matrix metallopeptidase 9 (MMP-9)] and systemic inflammation [high-sensitivity C-reactive protein (hs-CRP)] were assessed in the study population. All study participants underwent brachial artery flow mediated dilation (FMD) to estimate endothelial dysfunction. Disease severity (e-GFR) was assessed by a nephrologist. Results CKD patients showed markedly elevated levels of ADMA, ANGPTL2, MMP-9, and hs-CRP. FMD and eGFR were significantly decreased in cases, as compared to the controls. ADMA, ANGPTL2, MMP-9 and hs-CRP showed significant positive correlation with one another and significant negative correlation with FMD and disease severity. We also observed a significant negative correlation of FMD with disease severity and duration of CKD. In the multiple linear regression model, ADMA and ANGPTL2 were found to be independent predictors of FMD. Conclusion In CKD patients, there is significantly increased endothelial dysfunction and systemic inflammation, which showed a positive correlation with disease severity. Thus, the markers of endothelial dysfunction such as ADMA and ANGPTL2 can be used as predictors of CVD risk in CKD.Funding Information
- Jawaharlal Institute Of Postgraduate Medical Education and Research (JIP/Res/Intra-M.Sc/02/2015-16)
This publication has 33 references indexed in Scilit:
- Proteinuria and its relation to cardiovascular diseaseInternational Journal of Nephrology and Renovascular Disease, 2013
- Angiopoietin-Like Protein 2 Is Associated With Chronic Kidney Disease in a General Japanese PopulationCirculation Journal, 2013
- Indoxyl Sulfate–Induced Endothelial Dysfunction in Patients with Chronic Kidney Disease via an Induction of Oxidative StressClinical Journal of the American Society of Nephrology, 2011
- Matrix metalloproteinases (MMP-2,9) and their tissue inhibitors (TIMP-1,2) as novel markers of stress response and atherogenesis in children with chronic kidney disease (CKD) on conservative treatmentCell Stress and Chaperones, 2010
- CLINICAL EPIDEMIOLOGY OF CARDIOVASCULAR DISEASE IN CHRONIC KIDNEY DISEASEJournal of Renal Care, 2010
- Macrophage Matrix Metalloproteinase-9 Mediates Epithelial-Mesenchymal Transition in Vitro in Murine Renal Tubular CellsThe American Journal of Pathology, 2010
- The relation of C - reactive protein to chronic kidney disease in African Americans: the Jackson Heart StudyBMC Nephrology, 2010
- The Soluble VEGF Receptor sFlt1 Contributes to Endothelial Dysfunction in CKDJournal of the American Society of Nephrology, 2009
- Rosuvastatin and Cardiovascular Events in Patients Undergoing HemodialysisThe New England Journal of Medicine, 2009
- Asymmetric dimethylarginine (ADMA) is a novel emerging risk factor for cardiovascular disease and the development of renal injury in chronic kidney diseaseClinical and Experimental Nephrology, 2007