Bielach-Bazyluk Angelika, Czajkowska Katarzyna, Koc-Zorawska Ewa, Hryszko Tomasz, Zbroch Edyta
Department of Dermatology and Venereology, Medical University of Bialystok, 15-540 Bialystok, Poland.
Second Department of Nephrology, Hypertension and Internal Medicine with Dialysis Unit, Medical University of Bialystok, 15-276 Bialystok, Poland.
Int J Mol Sci. 2025 Sep 17;26(18):9033. doi: 10.3390/ijms26189033.
Sirtuin 1 (SIRT1) is implicated in oxidative stress, inflammation, and fibrosis-processes central to chronic kidney disease (CKD) and cardiovascular complications. Increased serum levels of SIRT1 have been reported in dialysis patients, and its role in peritoneal fibrosis, a leading cause of peritoneal dialysis failure, is well established. This study evaluated serum SIRT1 levels in 165 participants: peritoneally dialyzed patients (CAPD), conservatively treated CKD patients (CT), and healthy controls. Serum SIRT1 was measured by ELISA and analyzed alongside clinical factors. SIRT1 concentrations were markedly elevated in CAPD patients compared to both CT patients and controls. In CAPD patients, SIRT1 levels were not influenced by age, sex, dialysis adequacy, residual renal function, or comorbidities, but were higher in those with impaired left ventricular relaxation. Pharmacotherapy affected SIRT1 levels. Multivariate analysis identified phosphate and cholesterol as independent predictors of SIRT1. Our study suggests that serum SIRT1 levels may reflect diverse pathophysiological processes in CKD patients, including those on peritoneal dialysis. Elevated SIRT1 may indicate compensatory mechanisms related to renal dysfunction and cardiovascular stress. Future research on larger, pharmacologically homogeneous groups is warranted to clarify SIRT1's role in peritoneal fibrosis and its potential as a biomarker of cardiovascular and renal complications in CKD.
沉默调节蛋白1（SIRT1）与氧化应激、炎症和纤维化相关，这些过程是慢性肾脏病（CKD）及心血管并发症的核心。已有报道称透析患者血清SIRT1水平升高，且其在腹膜纤维化（腹膜透析失败的主要原因）中的作用已得到充分证实。本研究评估了165名参与者的血清SIRT1水平，包括腹膜透析患者（持续性非卧床腹膜透析，CAPD）、接受保守治疗的CKD患者（CT）和健康对照者。通过酶联免疫吸附测定法（ELISA）检测血清SIRT1，并结合临床因素进行分析。与CT患者和对照者相比，CAPD患者的SIRT1浓度显著升高。在CAPD患者中，SIRT1水平不受年龄、性别、透析充分性、残余肾功能或合并症的影响，但在左心室舒张功能受损的患者中较高。药物治疗会影响SIRT1水平。多变量分析确定磷酸盐和胆固醇是SIRT1的独立预测因子。我们的研究表明，血清SIRT1水平可能反映CKD患者（包括腹膜透析患者）的多种病理生理过程。SIRT1升高可能表明与肾功能不全和心血管应激相关的代偿机制。有必要对更大规模、药理学上同质的群体进行进一步研究，以阐明SIRT1在腹膜纤维化中的作用及其作为CKD心血管和肾脏并发症生物标志物的潜力。
