Clinical Department for Nephrology, Zvezdara University Medical Center, Dimitrija Tucovica 161, 11000 Belgrade, Serbia.
Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Vojvode Stepe 444a, 11042 Belgrade, Serbia.
Toxins (Basel). 2021 Sep 10;13(9):639. doi: 10.3390/toxins13090639.
Cardiovascular (CV) morbidity and mortality increase along with the progression of chronic kidney disease (CKD). The potential novel biomarkers of cardiotoxicity have been tested with the aim of the early detection of patients at high CV risk, and among them are markers of inflammation, oxidative stress, acute renal injury, and microRNAs. The study analyzed biomarkers in non-dialysis-dependent (NDD; stage 3a-4 CKD) and dialysis-dependent (DD) CKD patients. The prospective cohort study included 87 patients who were followed for 18 months, during which period newly occurred CV events were recorded. Cox regression analysis confirmed serum albumin, urea, interventricular septum thickness diameter (IVST), the use of calcium antagonist, and erythropoiesis-stimulating agent to be significant predictors of CV outcome. No significant difference was observed in biomarkers of inflammation, oxidative stress, acute kidney injury (IL-18, CRP, ferritin, IMA, SOD, NGAL, and KIM-1), and miR-133a, in regards to the presence/absence of CV event, CV death, and left ventricular hypertrophy. Serum albumin, urea, IVST, and the use of calcium antagonist and erythropoiesis-stimulating agents were confirmed to be factors associated with CV events in CKD patients. Apart from traditional risk factors, new research is needed to define novel and reliable biomarkers of cardiotoxicity in CKD patients.
心血管(CV)发病率和死亡率随着慢性肾脏病(CKD)的进展而增加。已经测试了潜在的新型心肌毒性生物标志物,目的是早期发现处于高 CV 风险的患者,其中包括炎症、氧化应激、急性肾损伤和 microRNAs 的标志物。该研究分析了非透析依赖型(NDD;3a-4 期 CKD)和透析依赖型(DD)CKD 患者的生物标志物。这项前瞻性队列研究纳入了 87 名患者,对他们进行了 18 个月的随访,在此期间记录了新发生的 CV 事件。Cox 回归分析证实血清白蛋白、尿素、室间隔厚度直径(IVST)、钙拮抗剂和促红细胞生成素的使用是 CV 结局的显著预测因子。在炎症、氧化应激、急性肾损伤(IL-18、CRP、铁蛋白、IMA、SOD、NGAL 和 KIM-1)和 miR-133a 的生物标志物方面,观察到 CV 事件、CV 死亡和左心室肥厚的有无之间没有显著差异。血清白蛋白、尿素、IVST 以及钙拮抗剂和促红细胞生成素的使用被证实是 CKD 患者 CV 事件的相关因素。除了传统的危险因素外,还需要新的研究来确定 CKD 患者心肌毒性的新型可靠生物标志物。