Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.
Nephrol Dial Transplant. 2010 Feb;25(2):581-6. doi: 10.1093/ndt/gfp358. Epub 2009 Jul 23.
Numbers of endothelial progenitor cells (EPC) have been shown to be decreased in subjects with end-stage renal disease (ESRD). It is not clear, however, whether dialysis modality affects circulating EPCs in ESRD subjects.
We examined the number of circulating EPCs in 67 continuous ambulatory peritoneal dialysis (CAPD) patients and age- and gender-matched 142 haemodialysis (HD) patients, and 78 subjects without chronic kidney disease. Arterial stiffness was analysed as pulse-wave velocity (PWV) for these patients, and their mutual relationship with circulating EPCs was examined. EPCs were measured as CD34(+) CD133(+) CD45(low) VEGFR2(+) cells determined by flow cytometry.
The EPC numbers exhibited a strong correlation (R(2) = 0.866) with endothelial-colony forming units on culture assay. The levels of EPCs in HD or CAPD subjects were significantly lower than those in control subjects. Among ESRD subjects, the levels of EPC were significantly higher in CAPD subjects than those in HD subjects. In ESRD subjects, PWV levels tended to be associated with EPCs (Rs = -0.131, P = 0.058). However, the significant relationship between dialysis modality and circulating EPCs was independent of the levels of PWV. The association of circulating EPCs with dialysis modality was significant even after adjusting for other potential confounders, including age, gender, blood pressure, history of cardiovascular diseases, presence of diabetes, blood haemoglobin level and treatments with angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker or statin.
CAPD treatment could be a positive regulator of number of circulating EPCs in subjects with ESRD, with the relationship independent of the status of arteriosclerosis.
研究表明，终末期肾病（ESRD）患者的内皮祖细胞（EPC）数量减少。然而，尚不清楚透析方式是否会影响 ESRD 患者的循环 EPC。
我们检查了 67 名持续非卧床腹膜透析（CAPD）患者、142 名血液透析（HD）患者和 78 名无慢性肾脏病患者的循环 EPC 数量，并对这些患者的动脉僵硬度进行脉搏波速度（PWV）分析，同时分析了循环 EPC 与这些指标的相互关系。EPC 通过流式细胞术测定 CD34(+) CD133(+) CD45(low) VEGFR2(+)细胞来测量。
EPC 数量与培养物中的内皮集落形成单位呈强相关（R(2) = 0.866）。HD 或 CAPD 患者的 EPC 水平明显低于对照组。在 ESRD 患者中，CAPD 患者的 EPC 水平明显高于 HD 患者。在 ESRD 患者中，PWV 水平与 EPC 呈正相关（Rs = -0.131，P = 0.058）。然而，透析方式与循环 EPC 之间的显著关系独立于 PWV 水平。即使在调整了其他潜在混杂因素（包括年龄、性别、血压、心血管疾病史、糖尿病、血血红蛋白水平以及血管紧张素转换酶抑制剂/血管紧张素 II 受体阻滞剂或他汀类药物治疗）后，循环 EPC 与透析方式的相关性仍然显著。
在 ESRD 患者中，CAPD 治疗可能是循环 EPC 数量的正向调节因子，这种关系与动脉粥样硬化状况无关。
