Oxidative stress and cardiac dysfunction in children with chronic renal failure on regular hemodialysis

Al‐Biltagi, Mohammed; Tolba, Osama A.; ElHafez, Maher Ahmed Abd; Abo-Elezz, Ahmed Abd ElBasset; Kady, Eman Kamel El; Hazza, Sahar Mohey El-din

doi:10.1007/s00467-016-3314-8

Cited by 12 publications

(12 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are only a limited number of clinical studies investigating the direct link between oxidative/nitrative stress and the development of LVH and heart failure in T4CRS. In a clinical cohort study, plasma GSH levels correlated with the degree of cardiac dysfunction checked by speckle tracking echocardiography in children with ESRD (Al-Biltagi et al, 2016 ). In another study, a cross-sectional analysis recruiting 78 adults with stage 3-4 CKD (eGFR: 25–60 mL/min) revealed that elevated plasma F2-isoprostane level as a marker of oxidative stress was associated with reduced heart rate variability (Fadaee et al, 2017 ).…”

Section: Pathways Of Cardiac Oxidative/nitrative Stress In T4crsmentioning

confidence: 99%

Mechanisms and Modulation of Oxidative/Nitrative Stress in Type 4 Cardio-Renal Syndrome and Renal Sarcopenia

Sárközy

Kovács

et al. 2018

Front. Physiol.

View full text Add to dashboard Cite

Chronic kidney disease (CKD) is a public health problem and a recognized risk factor for cardiovascular diseases (CVD). CKD could amplify the progression of chronic heart failure leading to the development of type 4 cardio-renal syndrome (T4CRS). The severity and persistence of heart failure are strongly associated with mortality risk in T4CRS. CKD is also a catabolic state leading to renal sarcopenia which is characterized by the loss of skeletal muscle strength and physical function. Renal sarcopenia also promotes the development of CVD and increases the mortality in CKD patients. In turn, heart failure developed in T4CRS could result in chronic muscle hypoperfusion and metabolic disturbances leading to or aggravating the renal sarcopenia. The interplay of multiple factors (e.g., comorbidities, over-activated renin-angiotensin-aldosterone system [RAAS], sympathetic nervous system [SNS], oxidative/nitrative stress, inflammation, etc.) may result in the progression of T4CRS and renal sarcopenia. Among these factors, oxidative/nitrative stress plays a crucial role in the complex pathomechanism and interrelationship between T4CRS and renal sarcopenia. In the heart and skeletal muscle, mitochondria, nicotinamide adenine dinucleotide phosphate (NADPH) oxidases, uncoupled nitric oxide synthase (NOS) and xanthine oxidase are major ROS sources producing superoxide anion (O2·−) and/or hydrogen peroxide (H2O2). O2·− reacts with nitric oxide (NO) forming peroxynitrite (ONOO−) which is a highly reactive nitrogen species (RNS). High levels of ROS/RNS cause lipid peroxidation, DNA damage, interacts with both DNA repair enzymes and transcription factors, leads to the oxidation/nitration of key proteins involved in contractility, calcium handling, metabolism, antioxidant defense mechanisms, etc. It also activates the inflammatory response, stress signals inducing cardiac hypertrophy, fibrosis, or cell death via different mechanisms (e.g., apoptosis, necrosis) and dysregulates autophagy. Therefore, the thorough understanding of the mechanisms which lead to perturbations in oxidative/nitrative metabolism and its relationship with pro-inflammatory, hypertrophic, fibrotic, cell death and other pathways would help to develop strategies to counteract systemic and tissue oxidative/nitrative stress in T4CRS and renal sarcopenia. In this review, we also focus on the effects of some well-known and novel pharmaceuticals, nutraceuticals, and physical exercise on cardiac and skeletal muscle oxidative/nitrative stress in T4CRS and renal sarcopenia.

show abstract

Section: Pathways Of Cardiac Oxidative/nitrative Stress In T4crsmentioning

confidence: 99%

Mechanisms and Modulation of Oxidative/Nitrative Stress in Type 4 Cardio-Renal Syndrome and Renal Sarcopenia

Sárközy

Kovács

et al. 2018

Front. Physiol.

View full text Add to dashboard Cite

show abstract

“…The risk of cardiovascular diseases (CVD) increases even in the early stages of CKD [ 4 ]. The pathogenesis of CVD in patients with CKD is complex and consists of traditional (e.g., arterial hypertension (AH) and diabetes mellitus (DM)) and uraemia-specific (e.g., oxidative stress, protein carbamylation, increased fibroblast growth factor 23 levels, anaemia and altered calcium and phosphate metabolism) factors [ 4 , 5 ]. CKD causes type 4 cardiorenal syndrome which is characterised by left ventricular (LV) hypertrophy, diastolic dysfunction (DD), deteriorated systolic heart function and increased risk of cardiovascular events [ 6 , 7 ].…”

Section: Background and Objectivesmentioning

confidence: 99%

Changes of Left and Right Ventricle Mechanics and Function in Patients with End-Stage Renal Disease Undergoing Haemodialysis

et al. 2018

View full text Add to dashboard Cite

Background and objectives: Chronic kidney disease (CKD) increases the risk of cardiovascular diseases even in its early stages and is associated with structural and functional cardiac abnormalities. The aim of this study was to use speckle-tracking echocardiography (STE) to evaluate left and right ventricle mechanics and function, markers of subclinical dysfunction in patients with end-stage renal disease (ESRD) undergoing haemodialysis. Methods: Patients with ESRD undergoing regular haemodialysis and with preserved left ventricle (LV) ejection fraction (EF) (n = 38) were enrolled in this retrospective study. The control group consisted of 32 age-matched persons with normal kidney function (glomerular filtration rate (GFR) >90 mL/min/1.73 m2 according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)). Conventional 2D echocardiography and STE were performed in all patients. Results: 70 individuals, 31 (44.29%) males and 39 (55.71%) females, were included in the study. There were no significant differences in age, sex and body surface area between the groups. LV end diastolic diameter did not differ between the groups, while LV myocardial mass index was higher in the group of patients on haemodialysis (111.64 ± 27.99 versus 84.21 ± 16.99, p < 0.001) and LV diastolic dysfunction (LVDD) was found in 31 (81.6%) patients of this group. LV global longitudinal strain (GLS) (−22.43 ± 2.71 versus −24.73 ± 2.03, p < 0.001) and LV global circumferential strain (GCS) at the mitral valve and papillary muscles levels (−18.73 ± 3.49 versus −21.67 ± 2.22, p < 0.001; −18.64 ± 2.75 versus −20.42 ± 2.38, p = 0.005, respectively) were significantly lower in haemodialysis group patients. The parameters of the right ventricle (RV) free wall longitudinal function including RV GLS (−22.63 ± 3.04 versus −25.45 ± 2.48, p < 0.001), were reduced in haemodialysis patients compared with the controls. However, RV fractional area change (FAC) did not differ between the groups (p = 0.19). Conclusion: Patients with ESRD and preserved LV ejection fraction undergoing haemodialysis had a higher prevalence of LVDD and impaired LV longitudinal and circumferential deformation indices, as well as reduced RV longitudinal function and deformation parameters compared with the age-matched healthy controls. STE helps to detect subclinical LV and RV dysfunction in chronic haemodialysis patients.

show abstract

“…Cardiovascular disease (CVD) is considered as the predominant cause of mortality and morbidity in chronic kidney disease (CKD) patients [1]. Left ventricular diastolic and systolic dysfunction and left ventricular hypertrophy (LVH) contribute to the increased cardiovascular mortality rate in these patients [2, 3]. Such changes have been observed in young adults and children on prolonged dialysis [4–6].…”

Section: Introductionmentioning

confidence: 99%

“…Myocardial function and LVH in CKD patients have been studied using conventional pulsed-wave Doppler echocardiography (cPWD) in both pediatric and adult patients on regular HD, and this method evaluates hydrodynamic responses, which are load-dependent, making it disadvantageous in end-stage renal disease (ESRD), where fluid status may change according to the patient’s condition [2–6]. Conventional pulsed-wave Doppler echocardiography only allows partially subjective semi-quantitative measurements.…”

Section: Introductionmentioning

confidence: 99%

Left ventricular dysfunction by conventional and tissue Doppler echocardiography in pediatric hemodialysis patients: relation with plasma brain natriuretic peptide levels

Mostafa

Sad

Elshamaa

et al. 2018

Arch Med Sci Atheroscler Dis

View full text Add to dashboard Cite

IntroductionTissue Doppler imaging (TDI) is a relatively new echocardiography method in children with chronic kidney disease (CKD). The aims of this study were to evaluate left ventricular (LV) diastolic function in pediatric CKD patients using conventional pulsed-wave Doppler echocardiography (cPWD) and TDI methods and correlate them with BNP levels.Material and methodsThirty children on regular hemodialysis (HD) were included. Left ventricular systolic and diastolic indices and BNP levels were measured immediately before and after HD.ResultsAfter HD, LV and left atrium diameters were significantly decreased (p < 0.001 and p < 0.001, respectively). Transmitral E velocity and E/A ratio decreased (p < 0.001 and p < 0.001, respectively). Also, there were significant decreases in the early diastolic velocity E’ of LV wall, septal wall, and anterior wall (p = 0.001, p = 0.004 and p < 0.001, respectively). Mean E/E’ ratio and ratios of septal and lateral walls were decreased significantly (p = 0.004, p = 0.002 and p = 0.017, respectively). BNP levels decreased significantly during HD when comparing concentrations before and after HD (p < 0.001). BNP strongly correlated with LV diastolic function indices (before HD: mean E/E’ (r = 0.401, p = 0.028), lateral E/E” (r = 0.291, p = 0.025), septal E’(r = –0.398, p = 0.029), lateral wall E’ (r = –0.452, p = 0.012) and mean E’ (r = –0.469, p = 0.009), after HD: mean E/E’ (r = 0.38, p = 0.038) and lateral E/E” (r = 0.474, p = 0.008) and lateral wall E’ (r = –0.270, p = 0.037)).ConclusionsThe cPWD and TDI-derived LV indices are influenced by HD. The diagnostic utility of BNP in the presence of deteriorating renal function may be compromised to some extent.

show abstract

Oxidative stress and cardiac dysfunction in children with chronic renal failure on regular hemodialysis

Abstract: Significant oxidative stress was present in children with ESRD and was correlated with the degree of cardiac dysfunction detected early using the new cardiac imaging modality, STE.

Cited by 12 publications

References 41 publications

Mechanisms and Modulation of Oxidative/Nitrative Stress in Type 4 Cardio-Renal Syndrome and Renal Sarcopenia

Mechanisms and Modulation of Oxidative/Nitrative Stress in Type 4 Cardio-Renal Syndrome and Renal Sarcopenia

Changes of Left and Right Ventricle Mechanics and Function in Patients with End-Stage Renal Disease Undergoing Haemodialysis

Left ventricular dysfunction by conventional and tissue Doppler echocardiography in pediatric hemodialysis patients: relation with plasma brain natriuretic peptide levels

Contact Info

Product

Resources

About