Endothelial Dysfunction and Fetuin A Levels Before and After Kidney Transplantation

Çağlar, Kayser; Yılmaz, Mahmut İlker; Sağlam, Mutlu; Çakır, Erdinç; Kılıç, Selim; Eyıleten, Tayfun; Sönmez, Alper; Oğuz, Yusuf; Öner, Köksal; Örs, Fatih; Vural, Abdülgaffar; Yenicesu, Müjdat

doi:10.1097/01.tp.0000251647.72673.c7

Cited by 36 publications

(29 citation statements)

References 30 publications

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“…In the two comparative studies, it was presented that HD patients have a higher CIMT than the control group and CIMT becomes normal again following a successful renal transplantation. 28,29 Our study also reveals that CIMT was significantly higher in HD patients than control group. This supports that cardiovascular risk was higher in this patient group due to some reasons related with uremia such as endothelial dysfunction, hyperparathyroidism, chronic inflammation, malnutrition and vascular calcification even in the absence of important cardiovascular risk factors such as DM and HT.…”

supporting

confidence: 59%

Echocardiographic evaluation of epicardial adipose tissue in non-diabetic, non-hypertensive hemodialysis patients

2013

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Turkey AbstractPurpose: It has been found out that the epicardial adipose tissue (EAT) measured by echocardiography is related with various metabolic parameters. Being accepted as the new cardiovascular risk indicator, there have been few studies on EAT in relation to the patients with end-stage renal failure. In our study, we aim to evaluate EAT and carotid intima media thickness (CIMT) in non-diabetic, non-hypertensive hemodialysis (HD) patients. Methods: Our study recruited 47 non-diabetic, non-hypertensive HD patients (22 males, 25 females, median age 54 (44.3-60.8) years) and an age-gender matched control group consisting 41 healthy subjects (17 males, 24 females, median age 52 (48-56) years). In all patients, EAT was measured by echocardiography and CIMT by ultrasonography; and routine laboratory parameters were studied. Results: In our study, we obtained laboratory findings matching with the profiles of uremic patients among HD patients and CIMT values of HD patients are significantly higher than that of the control group

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supporting

confidence: 59%

Echocardiographic evaluation of epicardial adipose tissue in non-diabetic, non-hypertensive hemodialysis patients

2013

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“…Notably, FMD increased in parallel with increased fetuin-A concentration, and in a multiple regression analysis fetuin-A was independently associated with FMD. In accordance, we have previously shown that the improvement in FMD after successful kidney transplantation was associated with increased fetuin-A levels (40). Taken together, because this study suggests that sevelamer has a beneficial effect on endothelial function, further mechanistic studies are needed to confirm this finding and elucidate potential pathophysiological mechanism(s).…”

Section: Discussionmentioning

confidence: 54%

Short-Term Treatment with Sevelamer Increases Serum Fetuin-A Concentration and Improves Endothelial Dysfunction in Chronic Kidney Disease Stage 4 Patients

Çağlar

Yılmaz²,

Sağlam³

et al. 2008

Clinical Journal of the American Society of Nephrology

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124

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Background and objectives: Vascular calcification and endothelial dysfunction contribute to the development of cardiovascular disease in patients with chronic kidney disease (CKD). Sevelamer, a non-calcium-based phosphate binder, has been shown to attenuate cardiovascular calcification in CKD patients, although the exact mechanism has not been clarified. This study was designed to investigate the effect of short-term sevelamer treatment on both serum fetuin-A concentrations and endothelial dysfunction seen in CKD patients.Design, setting, participants, & measurements: Fifty nondiabetic stage 4 CKD patients whose phosphate levels were >5.5 mg/dl were enrolled in this 8-wk randomized prospective study. Thirty-six healthy volunteers served as matched controls. Patients were treated with either sevelamer (n ‫؍‬ 25, 12 males) or calcium acetate (n ‫؍‬ 25, 13 males). Fetuin-A, high-sensitivity C-reactive protein, Ca ؋ PO 4 product, flow-mediated dilation (FMD), insulin, and homeostasis model assessment (HOMA) were obtained at baseline and after the treatment period.Results: As expected, CKD patients had significantly lower levels of fetuin-A and FMD, and significantly higher levels of intact parathyroid hormone, Ca ؋ PO 4 product, and high-sensitivity C-reactive protein than controls (P < 0.001 for all). The use of sevelamer led to a significant increase in the fetuin-A concentration with improvement in FMD, whereas no significant difference was observed in the calcium acetate group. In a multiple regression analysis, FMD levels were independently related to fetuin-A both before (␤ ‫؍‬ 0.63, P < 0.001) and after (␤ ‫؍‬ 0.38, P ‫؍‬ 0.004) treatment.Conclusions: This small, randomized, prospective study shows that short-term sevelamer treatment significantly increases fetuin-A levels and improves FMD in nondiabetic stage 4 CKD patients.

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“…The functions and regulatory mechanisms of fetuin-A remain to be fully elucidated and seem to differ according to the pathophysiological characteristics of the population studied. 5,9,10,21 Caglar et al 21 showed that the fetuin-A levels significantly increased after renal transplantation, that is, after a nearly complete restoration of the renal function. Recently, the same authors 22 hypothesized that fetuin-A may be one of the contributing factors for the development of endothelial dysfunction in CKD patients.…”

Section: Discussionmentioning

confidence: 99%

Subclinical atherosclerosis and fetuin-A plasma levels in essential hypertensive patients

et al. 2012

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The intima-media thickness (IMT) is considered as a surrogate marker for atherosclerotic disease. The aim of this study was to analyze the relationship of carotid IMT with fetuin-A in patients with essential hypertension (EH) and normal renal function. The plasma levels of fetuin-A, interleukin 6 (IL-6), tumor necrosis factor-a (TNF-a) and the biomarker of oxidative stress 8-isoPGF2alpha were assayed in samples from 105 untreated EH patients. Carotid IMT measurements were also performed. EH was studied overall and after dividing in EH with IMT X and o0.9 mm. All of the biomarkers were significantly different between the two subgroups, in particular, the fetuin-A level was lower in the patients with an IMT X0.9 mm. In the overall group, the linear analysis of correlation demonstrated that the IMT was significantly inversely correlated with the fetuin-A level (r ¼ À0.40, Po0.0001) and directly with TNF-a (r ¼ 0.39, Po0.0001), IL-6 (r ¼ 0.38, Po0.0001) and 8-iso-PGF2alpha (r ¼ 0.356, Po0.0003). The multiple regression analysis performed that assigned IMT as a dependent variable showed that fetuin-A (b ¼ À0.268, Po0.0001) was independently correlated with the IMT. Receiver-operator curves demonstrated that fetuin-A levels have a predictive power of IMT40.9 mm (AUC (area under the curve) 0.738, Po0.0001). Our results suggest that in EH, fetuin-A is associated with the IMT independently of oxidative stress and renal function, thus predicting increases in the IMT.

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Endothelial Dysfunction and Fetuin A Levels Before and After Kidney Transplantation

Abstract: The results of the present study suggest that low serum fetuin A levels in CKD may contribute to impaired endothelial functions in CKD. Future studies should clarify the role of fetuin A levels in cardiovascular outcomes of CKD.

Cited by 36 publications

References 30 publications

Echocardiographic evaluation of epicardial adipose tissue in non-diabetic, non-hypertensive hemodialysis patients

Echocardiographic evaluation of epicardial adipose tissue in non-diabetic, non-hypertensive hemodialysis patients

Short-Term Treatment with Sevelamer Increases Serum Fetuin-A Concentration and Improves Endothelial Dysfunction in Chronic Kidney Disease Stage 4 Patients

Subclinical atherosclerosis and fetuin-A plasma levels in essential hypertensive patients

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