Oxidative stress, advanced glycation end product, and coronary artery calcification in hemodialysis patients

Abstract

Coronary artery calcification is an index of the severity of atherosclerotic vascular disease, and may predict future adverse cardiovascular events in uremic patients undergoing hemodialysis (HD). HD patients are exposed to oxidative stress, and show high plasma levels of advanced glycation end products (AGEs). The association between oxidative stress, AGEs, established cardiovascular risk factors, and coronary artery calcification score (CACS) was studied in 225 HD patients (123 male, 102 female patients). CACS was measured by using multi-detector row computed tomography. Age, systolic blood pressure, calcium, calcium x phosphate, malondialdehyde, lipid peroxides, and pentosidine were significantly and positively correlated with CACS. Duration on HD tended to be positively correlated with CACS. From the independent variables included in the forward stepwise multiple linear regression analysis, only age, systolic blood pressure, lipid peroxides, calcium, and pentosidine were independently associated with CACS. The odds ratios for past history of coronary artery disease and the presence of diabetes mellitus for high CACS (> or =100) were 6.25 (95% confidence interval; 1.83-21.4) and 2.03 (95% confidence interval; 1.02-4.05), respectively. The plasma pentosidine was significantly and positively correlated with indoxyl sulfate. In conclusion, in addition to such traditional cardiovascular risk factors as past history, diabetes mellitus, aging, systolic blood pressure and calcium overload, oxidative stress (lipid peroxides), and AGE (pentosidine) are associated with extensive coronary artery calcification in HD patients. Lipid peroxidation and glycoxidation may be involved in the pathogenesis of coronary artery calcification.

Advanced Glycation End-products Enhance Calcification in Vascular Smooth Muscle Cells

“…Recent research suggests that advanced glycation end-products (AGEs), senescent macroprotein derivatives formed at an accelerated rate in diabetes, are closely correlated with vascular calcification. 3 Since vascular smooth muscle cells (VSMCs) contribute significantly to the active regulation of vascular calcification, 4,5 this study was designed to investigate whether AGEs can induce the osteoblastic differentiation of rat aortic VSMCs and to study the involvement of the AGE receptor (RAGE).…”

Sarpogrelate Hydrochloride, a Selective 5-HT2AReceptor Antagonist, Improves Skin Perfusion Pressure of the Lower Extremities in Hemodialysis Patients with Peripheral Arterial Disease

“…19 Pentosidine, an AGE, is reportedly associated with extensive coronary artery calcification in HD patients. 20 In this study, pentosidine levels decreased following the administration of sarpogrelate and cilostazol; therefore, both drugs lower oxidative stress.…”

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

“…По-відомлень щодо зв'язку кардіоваскулярної кальцифікації та процесів запалення у до-ступній літературі багато [22,30,[40][41][42], проте більшість даних є фрагментарні, розріз-нені [22,42], розглядаються в контексті МІА-синдрому [41] і стосуються, за виключенням окремих праць [40,43], діаліззалежної ХХН. Погляди науковців щодо ролі порушень ліпід-ного обміну в реалізації механізмів судинної/ клапанної кальцифікації при ХХН неодноз-начні [3,22,42,44], а вивчення маркерів ОС як чинника прогресування атеросклеротич-ного пошкодження і кальцифікації [1,19] проводилось головним чином у пацієнтів на ГД [45,46].…”