Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain.
Redes Temáticas de Investigación Cooperativa en Salud-Red Española de Investigación Renal, RD16/0009, Instituto de Salud Carlos III, Madrid, Spain.
Am J Physiol Renal Physiol. 2017 Apr 1;312(4):F673-F681. doi: 10.1152/ajprenal.00013.2016. Epub 2017 Jan 11.
Patients with Stage 5 chronic kidney disease who are on hemodialysis (HD) remain in a chronic inflammatory state, characterized by the accumulation of uremic toxins that induce endothelial damage and cardiovascular disease (CVD). Our aim was to examine microvesicles (MVs), monocyte subpopulations, and angiopoietins (Ang) to identify prognostic markers in HD patients with or without diabetes mellitus (DM). A total of 160 prevalent HD patients from 10 centers across Spain were obtained from the Biobank of the Nephrology Renal Network (Madrid, Spain): 80 patients with DM and 80 patients without DM who were matched for clinical and demographic criteria. MVs from plasma and several monocyte subpopulations (CD14/CD16, CD14/CD16) were analyzed by flow cytometry, and the plasma concentrations of Ang1 and Ang2 were quantified by ELISA. Data on CVD were gathered over the 5.5 yr after these samples were obtained. MV level, monocyte subpopulations (CD14/CD16 and CD14/CD16), and Ang2-to-Ang1 ratios increased in HD patients with DM compared with non-DM patients. Moreover, MV level above the median (264 MVs/µl) was associated independently with greater mortality. MVs, monocyte subpopulations, and Ang2-to-Ang1 ratio can be used as predictors for CVD. In addition, MV level has a potential predictive value in the prevention of CVD in HD patients. These parameters undergo more extensive changes in patients with DM.
患有 5 期慢性肾脏病并接受血液透析 (HD) 的患者仍处于慢性炎症状态，其特征是尿毒症毒素的积累导致内皮损伤和心血管疾病 (CVD)。我们的目的是研究微泡 (MVs)、单核细胞亚群和血管生成素 (Ang)，以确定伴有或不伴有糖尿病 (DM) 的 HD 患者的预后标志物。总共从西班牙的 10 个中心的肾脏病网络的生物银行中获得了来自西班牙马德里的 160 名患有 DM 和 80 名无 DM 的 HD 患者：80 名患有 DM 和 80 名无 DM 的患者，这些患者在临床和人口统计学标准上相匹配。通过流式细胞术分析来自血浆的 MVs 和几种单核细胞亚群 (CD14/CD16、CD14/CD16)，并通过 ELISA 定量测定 Ang1 和 Ang2 的血浆浓度。在获得这些样本后的 5.5 年内收集了 CVD 数据。与非 DM 患者相比，患有 DM 的 HD 患者的 MV 水平、单核细胞亚群 (CD14/CD16 和 CD14/CD16) 和 Ang2/Ang1 比值增加。此外，MV 水平高于中位数 (264 个/µl) 与更高的死亡率独立相关。MVs、单核细胞亚群和 Ang2/Ang1 比值可作为 CVD 的预测因子。此外，MV 水平在预防 HD 患者的 CVD 方面具有潜在的预测价值。这些参数在患有 DM 的患者中发生了更广泛的变化。
