Stritch School of Medicine, Loyola University Chicago, Maywood, IL, USA.
Department of Pathology & Laboratory Medicine, and Department of Pharmacology and Neuroscience, Cardiovascular Research Institute, Health Science Division, Loyola University Chicago, Maywood, IL, USA.
Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241263101. doi: 10.1177/10760296241263101.
Cardiovascular disease is a prevalent complication in patients with end-stage renal disease (ESRD) on maintenance hemodialysis. In the ESRD patient population, cardiovascular mortality is 20 times higher compared to the general population. The strong relationship between both illnesses can be explained through cardiorenal syndrome (CRS). CRS encompasses a spectrum of disorders involving both the heart and kidneys in which acute or chronic dysfunction in one organ may induce a similar effect in the other organ. Current literature reveals that inflammation and thrombosis are integral to CRS development. Hence, this study aims to demonstrate whether thromboinflammatory biomarkers and laboratory parameters correlate with ESRD progression and the development of CRS. Ninety-five ESRD patients were recruited at Loyola University Medical Center hemodialysis unit. Epic chart analysis was used to determine patients with CRS. Biomarkers (C-reactive protein, tumor necrosis factor alpha, interleukin-6, Annexin V, L-fatty acid binding protein, monocyte chemoattractant protein 1, nitric oxide, von Willebrand factor, D-dimer, and plasminogen activator inhibitor-1) were profiled using the enzyme-linked immunosorbent assay method in patients with and without CRS in the ESRD cohort. All biomarkers were significantly elevated in ESRD patients compared to normal controls ( < .05) and laboratory parameters, ferritin (521.99 ± 289.33) and PTH (442.91 ± 1.50). Through EPIC chart analysis 47% of ESRD patients have CRS. D-dimer and TNF-α were significantly elevated in patients with CRS compared to patients without CRS. This study suggests that biomarkers, D-dimer, and TNF-α, can be good predictors of CRS in ESRD patients.
心血管疾病是接受维持性血液透析的终末期肾病(ESRD)患者的常见并发症。在 ESRD 患者人群中,心血管死亡率比普通人群高 20 倍。这两种疾病之间的密切关系可以通过心肾综合征(CRS)来解释。CRS 涵盖了一系列涉及心脏和肾脏的疾病,其中一个器官的急性或慢性功能障碍可能会对另一个器官产生类似的影响。目前的文献表明,炎症和血栓形成是 CRS 发展的重要因素。因此,本研究旨在证明血栓炎症生物标志物和实验室参数是否与 ESRD 进展和 CRS 的发展相关。
在洛约拉大学医学中心血液透析单位招募了 95 名 ESRD 患者。通过 Epic 图表分析确定 CRS 患者。使用酶联免疫吸附测定法对 ESRD 队列中有无 CRS 的患者进行生物标志物(C 反应蛋白、肿瘤坏死因子-α、白细胞介素-6、膜联蛋白 V、L-脂肪酸结合蛋白、单核细胞趋化蛋白 1、一氧化氮、血管性血友病因子、D-二聚体和纤溶酶原激活物抑制剂-1)的分析。与正常对照组相比,所有生物标志物( < .05)和实验室参数(铁蛋白 521.99 ± 289.33 和 PTH 442.91 ± 1.50)在 ESRD 患者中均显著升高。通过 EPIC 图表分析,47%的 ESRD 患者患有 CRS。与无 CRS 的患者相比,CRS 患者的 D-二聚体和 TNF-α显著升高。
本研究表明,生物标志物 D-二聚体和 TNF-α可作为 ESRD 患者 CRS 的良好预测指标。
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