Research Unit, Södertälje Hospital, Södertälje, Sweden.
Karolinska Institutet at Danderyds Hospital (KIDS), Stockholm, Sweden.
Clin Hemorheol Microcirc. 2019;72(2):161-168. doi: 10.3233/CH-180444.
Injury (shedding) of the endothelial glycocalyx layer, which alters local blood flow and microvascular permeability, is assessed by measuring components of this layer in circulating blood. The influence of renal function on their concentrations is unknown.
Plasma and urine concentrations of three shedding products (syndecan-1, hyaluronic acid, and heparan sulfate) and creatinine were measured over 5 hours in 15 healthy volunteers and 15 postoperative patients; this guaranteed a spread of kidney functions. Renal clearances were calculated.
Low renal clearances of syndecan-1 (mean 3.5 mL/min) and hyaluronic acid (0.8 mL/min) correlated inversely with the 6-fold variability in the plasma concentrations of these substances (r = - 0.45 and- 0.49). Low creatinine clearance correlated inversely (r = - 0.60) and plasma creatinine directly (r = 0.52) with the two-fold variability in heparan sulfate, which was the only shedding substance that also correlated with C-reactive protein (r = 0.51) and, therefore, showed higher concentrations after surgery.
The present explorative study suggests that a 6-fold variability in the plasma concentrations of three commonly measured endothelial shedding products can be understood by the kidney's ability to excrete them. This finding has implications when interpreting results of studies where shedding is assessed.
内皮糖萼层的损伤（脱落）会改变局部血流和微血管通透性，通过测量循环血液中该层的成分来评估。其浓度受肾功能的影响尚不清楚。
在 15 名健康志愿者和 15 名术后患者中，5 小时内连续测量三种脱落产物（硫酸乙酰肝素、透明质酸和 syndecan-1）和肌酐的血浆和尿液浓度；这保证了肾功能的广泛分布。计算了肾清除率。
低肾清除率的 syndecan-1（平均 3.5ml/min）和透明质酸（0.8ml/min）与这些物质的血浆浓度的 6 倍变异性呈负相关（r=-0.45 和-0.49）。低肌酐清除率与肝素硫酸的两倍变异性呈负相关（r=-0.60），与血浆肌酐呈直接相关（r=0.52），肝素硫酸是唯一与 C-反应蛋白相关（r=0.51）的脱落物质，因此术后浓度较高。
本探索性研究表明，三种常用内皮脱落产物的血浆浓度的 6 倍变异性可以通过肾脏的排泄能力来解释。当解释脱落物评估的研究结果时，这一发现具有重要意义。
