Department of Nephrology and Transplantology, Medical University, Bialystok, 15-540 Bialystok, Zurawia 14, Poland.
Clin Chim Acta. 2010 Oct 9;411(19-20):1412-20. doi: 10.1016/j.cca.2010.06.019. Epub 2010 Jun 22.
Endothelium is the largest organ in the body strategically located between the wall of blood vessels and the blood stream. The human body contains approximately 10(13) endothelial cells weighing approximately 1kg, and covering a surface area of 4000 to 7000m(2) equivalent to the soccer playground. Hypertension and shear stress, inflammation, diabetes-associated factors such as advanced glycated end products, and uremic toxins are some of the prevalent risk factors of endothelial dysfunction in chronic kidney disease. In renal failure endothelial dysfunction and atherosclerosis are almost universal, as well as cardiovascular complications. Endothelial cell damage or injury is invariably associated with such clinical conditions as thrombosis, hypertension, renal failure and atherosclerosis and may be also responsible for accelerated atherosclerosis in patients with chronic renal failure. Traditional risk factor cannot explain the high prevalence and incidence of cardiovascular disease in chronic kidney disease, therefore other non-traditional risk factors such as endothelial dysfunction, oxidative stress or insulin resistance have increasingly been studied. In this review paper mechanism of endothelial dysfunction, including the role of nitric oxide pathway, adipocytokines and hemodialysis-induced endothelial dysfunction is discussed.
内皮细胞是人体最大的器官，位于血管壁和血液之间，具有战略意义。人体内大约有 10(13)个内皮细胞，重量约为 1 公斤，覆盖面积为 4000 到 7000m(2)，相当于一个足球场。高血压和切应力、炎症、糖尿病相关因素如晚期糖基化终产物和尿毒症毒素等，都是慢性肾脏病内皮功能障碍的常见危险因素。在肾功能衰竭中，内皮功能障碍和动脉粥样硬化几乎是普遍存在的，还有心血管并发症。内皮细胞损伤或损伤总是与血栓形成、高血压、肾功能衰竭和动脉粥样硬化等临床情况相关，也可能是慢性肾功能衰竭患者加速动脉粥样硬化的原因。传统的危险因素无法解释慢性肾脏病中心血管疾病的高患病率和发病率，因此其他非传统的危险因素，如内皮功能障碍、氧化应激或胰岛素抵抗，越来越受到研究关注。在这篇综述文章中，讨论了内皮功能障碍的机制，包括一氧化氮途径、脂肪细胞因子和血液透析诱导的内皮功能障碍的作用。
