Department of Pathology, Loyola University Medical Center, Maywood, IL, USA.
Department of Nephrology, Loyola University Medical Center, Maywood, IL, USA.
Clin Appl Thromb Hemost. 2018 Dec;24(9_suppl):248S-254S. doi: 10.1177/1076029618807565. Epub 2018 Oct 22.
Patients with stage 5 chronic kidney disease (CKD5D) have a higher risk of developing neurocognitive deficits. Stroke, cervical carotid artery disease (CCAD), and intracranial atherosclerotic disease (ICAD) are causes of such deficits in CKD5D. Chronic inflammation from renal failure elevates risk for these diseases through oxidative stress and vascular dysfunction. The adverse impact on the carotid and intracranial vasculatures contributes to the multifactorial pathophysiology of stroke. Eleven plasma biomarker levels in patients with CKD5D (n = 97) and healthy controls (n = 17-50) were measured using sandwich enzyme-linked immunosorbent assay (ELISA) method. Of the 97 patients with CKD5D, 24 had CCAD, 19 had ICAD, and 23 had acute stroke. Elevations in NACHT, LRR, and PYD domains-containing protein 3 (NALP3) levels in patients with CKD5D (+)CCAD (1.80 ± 0.11 ng/mL) compared to patients with (-)CCAD (1.55 ± 0.08 ng/mL) were statistically significant ( = .0299). Differences in D-dimer levels were also found to be statistically significant ( = .0258) between CKD5D (+)stroke (1.83 ± 0.42 μg/mL) and (-)stroke (0.89 ± 0.13 μg/mL) groups. The ages of the (+) neurovascular disease groups were found to be significantly elevated compared to the (-) neurovascular disease groups ( = .0002 carotid AD; < .0001 ICAD; = .0157 stroke). D-dimer levels were positively correlated with age in CKD5D ( = .0375). With the possible exception of NALP3 for CCAD, profiling levels of specific biomarkers for risk stratification of neurovascular diseases in the CKD5D population warrants further investigation.
患有 5 期慢性肾脏病 (CKD5D) 的患者发生神经认知功能障碍的风险更高。卒中、颈总动脉疾病 (CCAD) 和颅内动脉粥样硬化性疾病 (ICAD) 是 CKD5D 患者发生此类疾病的原因。肾衰竭引起的慢性炎症通过氧化应激和血管功能障碍增加了这些疾病的风险。这些疾病对颈内和颅内血管的不利影响导致了卒中的多因素病理生理学。使用夹心酶联免疫吸附测定 (ELISA) 法测量了 97 例 CKD5D 患者 (n = 97) 和健康对照者 (n = 17-50) 的 11 种血浆生物标志物水平。在 97 例 CKD5D 患者中，24 例有 CCAD，19 例有 ICAD，23 例有急性卒中。与无 CCAD 的患者 (1.55 ± 0.08 ng/mL) 相比，CKD5D (+)CCAD 患者的 NACHT、LRR 和 PYD 结构域包含蛋白 3 (NALP3) 水平升高 (1.80 ± 0.11 ng/mL) 具有统计学意义 (=.0299)。CKD5D (+)卒中 (1.83 ± 0.42 μg/mL) 与 (-)卒中 (0.89 ± 0.13 μg/mL) 组之间 D-二聚体水平的差异也具有统计学意义 (=.0258)。神经血管疾病 (+)组的年龄明显高于神经血管疾病 (-)组 (=.0002 颈动脉 AD；<.0001 ICAD；=.0157 卒中)。CKD5D 中 D-二聚体水平与年龄呈正相关 (=.0375)。除了 CCAD 的 NALP3 外，进一步研究 CKD5D 人群中特定生物标志物的水平是否可用于神经血管疾病的风险分层。
