Sági Balázs, Kun Szilárd, Jakabfi-Csepregi Rita Klaudia, Sulyok Endre, Csiky Botond
2nd Department of Internal Medicine and Nephrology, Diabetes Center, Clinical Center, Medical School, University of Pécs, 7624 Pécs, Hungary.
Fresenius Medical Care Dialysis Centers, 7624 Pécs, Hungary.
J Clin Med. 2023 Nov 29;12(23):7384. doi: 10.3390/jcm12237384.
Chronic hemodialysis (HD) patients have a very high cardiovascular risk. Acute vascular changes during dialysis mediated by factors of the endothelium may have a crucial role in this. The aim of this article is to study the acute vascular changes during HD.
In 29 consecutive chronic HD patients (age: 65.6 ± 10.4 years), their pre-, mid-, and post-HD plasma syndecan-1 (SDC-1) and endothelin-1 (ET-1) levels were measured. Applanation tonometry was performed before HD.
Their SDC-1 levels increased during HD ( = 0.004). Males had higher ET-1 levels. The patients were divided into two groups based on their pre-HD pulse wave velocity (PWV): PWV ≥ 12 m/s and PWV < 12 m/s. The pre-HD and mid-HD SDC-1 levels were higher in the group with a PWV ≥ 12 m/s (10.174 ± 2.568 vs. 7.928 ± 1.794 ng/mL, = 0.013, and 10.319 ± 3.482 vs. 8.248 ± 1.793 ng/mL, = 0.044, respectively). The post-HD ET-1 levels were higher in the patient group with a PWV ≥ 12 m/s (10.88 ± 3.00 vs. 8.05 ± 3.48 pg/l, = 0.027). Patients with a PWV ≥ 12 m/s had higher pre-HD peripheral and aortic systolic blood pressures ( < 0.05). The total cholesterol correlated with the SDC-1 decrease during HD (r = 0.539; = 0.008). The pre-, mid-, and post-HD SDC-1 correlated with ultrafiltration (r = 0.432, = 0.019; r = 0.377, = 0.044; and r = 0.401, = 0.012, respectively).
SDC-1 and ET-1 contribute to the vascular changes observed during HD, and they have correlations with some cardiovascular risk factors.
慢性血液透析（HD）患者具有极高的心血管风险。由内皮因子介导的透析过程中的急性血管变化可能在其中起关键作用。本文旨在研究血液透析期间的急性血管变化。
对29例连续性慢性血液透析患者（年龄：65.6±10.4岁），检测其透析前、透析中及透析后血浆syndecan - 1（SDC - 1）和内皮素 - 1（ET - 1）水平。在透析前进行压平眼压测量。
他们的SDC - 1水平在透析期间升高（P = 0.004）。男性的ET - 1水平较高。根据透析前脉搏波速度（PWV）将患者分为两组：PWV≥12 m/s组和PWV < 12 m/s组。PWV≥12 m/s组透析前和透析中的SDC - 1水平较高（分别为10.174±2.568 vs. 7.928±1.794 ng/mL，P = 0.013；以及10.319±3.482 vs. 8.248±1.793 ng/mL，P = 0.044）。PWV≥12 m/s患者组透析后的ET - 1水平较高（10.88±3.00 vs. 8.05±3.48 pg/l，P = 0.027）。PWV≥12 m/s的患者透析前外周和主动脉收缩压较高（P < 0.05）。总胆固醇与透析期间SDC - 1的降低相关（r = 0.539；P = 0.008）。透析前、透析中及透析后的SDC - 1与超滤相关（分别为r = 0.432，P = 0.019；r = 0.377，P = 0.044；以及r = 0.401，P = 0.012）。
SDC - 1和ET - 1促成了血液透析期间观察到的血管变化，并且它们与一些心血管危险因素相关。
