Hemodialysis-Induced Release of Hemoglobin Limits Nitric Oxide Bioavailability and Impairs Vascular Function

Meyer, Christian; Heiß, Christian; Drexhage, Christine; Kehmeier, Eva; Balzer, Jan C.; Mühlfeld, Anja; Merx, Marc W.; Lauer, Thomas; Kühl, Harald P.; Floege, Jürgen; Kelm, Malte; Rassaf, Tienush

doi:10.1016/j.jacc.2009.07.068

Cited by 99 publications

(106 citation statements)

References 23 publications

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“…We previously showed that free hemoglobin can impair endothelial function potentially by scavenging of endothelium-derived NO. 32 We observed consistently a strong inverse univariate correlation between FMD and free hemoglobin (r ¼ À0.79, p ¼ 0.001) ( Figure 5 and 6). …”

Section: Lvad Implantation and Htx Lead To Improved Microvascular Funsupporting

confidence: 54%

“…47 However, even low levels of free hemoglobin may have pathophysiologic consequences. 32 Mechanistically, NO reacts with oxyhemoglobin in a rapid and irreversible reaction that produces nitrate and methemoglobin. Small amounts of cell-free hemoglobin and RBC microparticles are sufficient to offset endothelial NO production completely and result in endothelial dysfunction.…”

Section: Figurementioning

confidence: 99%

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Macrovascular and microvascular function after implantation of left ventricular assist devices in end-stage heart failure: Role of microparticles

Sansone¹,

Stanske²,

Keymel³

et al. 2015

The Journal of Heart and Lung Transplantation

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Section: Lvad Implantation and Htx Lead To Improved Microvascular Funsupporting

confidence: 54%

Section: Figurementioning

confidence: 99%

Macrovascular and microvascular function after implantation of left ventricular assist devices in end-stage heart failure: Role of microparticles

Sansone¹,

Stanske²,

Keymel³

et al. 2015

The Journal of Heart and Lung Transplantation

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“…The mechanism of endothelial dysfunction induced by HD is multifactorial. Decreased NO formation by accumulated endogenous NO synthase inhibitors or increased inactivation and scavenging of NO is considered responsible (14,(32)(33)(34)(35)(36). Corroborating previous findings, we observed an acute decrease in endothelium-dependent vasodilation after a single HD session, and we showed additional impairment, even during HD (14,37).…”

Section: Esrd and Atherosclerosismentioning

confidence: 99%

“…Vascular dysfunctions ascribed to patients with ESRD are further perpetuated by impaired nitric oxide (NO) bioavailability. Importantly, hemodialysis (HD) itself acutely impairs endothelial function through reduction of NO bioactivity (14).…”

Section: Introductionmentioning

confidence: 99%

Vasculoprotective Effects of Dietary Cocoa Flavanols in Patients on Hemodialysis

Rassaf

Rammos

Hendgen‐Cotta

et al. 2016

Clinical Journal of the American Society of Nephrology

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Background and objectives Hemodialysis (HD) per se entails vascular dysfunction in patients with ESRD. Endothelial dysfunction is a key step in atherosclerosis and is characterized by impaired flow-mediated dilation (FMD). Interventional studies have shown that cocoa flavanol (CF)-rich supplements improve vascular function. Aim of this study was to investigate the effect of flavanol-rich bioactive food ingredients on acute and chronic HD-induced vascular dysfunction in ESRD.Design, setting, participants, & measurements We conducted a randomized, double-blind, placebo-controlled trial from 2012 to 2013. Fifty-seven participants were enrolled, ingested CF-rich beverages (900 mg CF per study day), and were compared with those ingesting CF-free placebo. This included (1) a baseline cross-over acute study to determine safety and efficacy of CF and (2) a subsequent chronic parallel group study with a 30-day follow-up period to study effects of CF on HD-mediated vascular dysfunction entailing (3) an acute substudy during HD in flavanol-naive patients and (4) an acute on chronic study during HD. Primary and secondary outcome measures included changes in FMD and hemodynamics.Results CF ingestion was well tolerated. Acute ingestion improved FMD by 53% (3.260.6% to 4.860.9% versus placebo, 3.260.7% to 3.360.8%; P,0.001), with no effects on BP or heart rate. A 30-day ingestion of CF led to an increase in baseline FMD by 18% (3.460.9% to 3.960.8% versus placebo, 3.560.7% to 3.560.7%; P,0.001), with reduced diastolic BP (73612 to 69611 mmHg versus placebo, 70611 to 73613 mmHg; P=0.03) and increased heart rate (70612 to 74613 bpm versus placebo, 75615 to 74613 bpm; P=0.01). No effects were observed for placebo. Acute ingestion of CF during HD alleviated HD-induced vascular dysfunction (3.460.9% to 2.760.6% versus placebo, 3.560.7% to 2.060.6%; P,0.001). This effect was sustained throughout the study (acute on chronic, 3.960.9% to 3.060.7% versus placebo, 3.560.7% to 2.260.6; P=0.01).Conclusions Dietary CF ingestion mitigates acute HD-induced and chronic endothelial dysfunction in patients with ESRD and thus, improves vascular function in this high-risk population. Larger clinical trials are warranted to test whether this translates into an improved cardiovascular prognosis in patients with ESRD.

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“…Згідно з даними Meyer і співавт. [85], один сеанс ГД погіршував ендотелійзалежну ва-зодилатацію; в інших працях -остання не змінювалась [86] або покращувалась [87]. Вміст стабільних метаболітів NO після сеан-су ГД змінювався [88][89][90], а дослідження, прис вячені вивченню динаміки циркулюю чих ендотеліальних клітин як морфологічного маркера пошкодження ендотелію протягом ГД, поодинокі [91].…”

Section: сучасні тенденції розвитку науки індуктори та інгібітори каunclassified

Calcification of Heart and Vessels in Chronic Kidney Disease: Problems of Etiology and Pathogenesis

Susla¹,

Gozhenko²,

Bergier³

et al. 2017

Fiziol Zh

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Hemodialysis-Induced Release of Hemoglobin Limits Nitric Oxide Bioavailability and Impairs Vascular Function

Cited by 99 publications

References 23 publications

Macrovascular and microvascular function after implantation of left ventricular assist devices in end-stage heart failure: Role of microparticles

Macrovascular and microvascular function after implantation of left ventricular assist devices in end-stage heart failure: Role of microparticles

Vasculoprotective Effects of Dietary Cocoa Flavanols in Patients on Hemodialysis

Calcification of Heart and Vessels in Chronic Kidney Disease: Problems of Etiology and Pathogenesis

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