Novosti
Khirurgii

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Year 2019 Vol. 27 No 5

GENERAL & SPECIAL SURGERY

R.E. KALININ, I.A. SUCHKOV, A.A. EGOROV, A.A. NIKIFOROV, N.D. MZHAVANADZE

MARKERS OF ENDOTHELIAL DYSFUNCTION IN PRIMARY HEMODIALYSIS PATIENTS

Ryazan State Medical University, Ryazan,
The Russian Federation

Objective. To evaluate the markers of the endothelial dysfunction in patients on hemodialysis with native arteriovenous fistula in different terms.
Methods. An open prospective study included 45 subjects with end-stage chronic kidney disease of the 5th stage with a native arteriovenous fistula for hemodialysis. At baseline, 1, 6, and 12 months after the operation the levels of asymmetric dimethylarginine ADMA, advanced oxidation protein products AOPP, endothelin-1, adhesion molecules (VCAM, ICAM), C reactive protein (CRP), angiotensin-2, selectin (Sl), copper zinc superoxide dismutase (Cu/Zn-SOD) and OxyStat assay.
Results. Increased levels of ADMA and AOPP were registered in patients with the arteriovenous fistula thrombosis after 1, 6, and 12 months as compared to the subjects with normal fistula function (ð<0.01). Total peroxide concentration was increased after 6 and 12 months in patients with thrombosis (ð<0.01). Endothelin 1 level was increased after 6 and 12 months in patients with fistula thrombosis (ð<0.05). CRP level was elevated in patients with thrombosis after 1, 6, and 12 months (ð<0.01). In subjects with normal fistula function ICAM level decreased after 6 and 12 months (ð<0.01), VCAM level increased after 1 and decreased after 6 months as compared to baseline (ð<0.01). Selectin sL level increased after 1, 6, and 12 months in subjects with thrombosis. Cu/Zn-SOD concentration in patients with fistula thrombosis was lower at baseline and increased at 12 months (ð<0.01). Angiotensin 2 level in subjects with thrombosis was lower at baseline and increased after 6 and 12 months (ð<0.01).
Conclusions. Endothelial dysfunction is characteristic for dialysis patients. Increased levels the endothelial dysfunction markers are associated with thrombosis of native arteriovenous fistulas.

Keywords: endothelial dysfunction, hemodialysis, arteriovenous fistula, thrombosis, endothelin, oxidative stress
p. 505-514 of the original issue
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Address for correspondence:
390026, The Russian Federation,
Ryazan, Vysokovol’tnaya Str., 9,
Ryazan State Medical University,
Department of Cardiovascular,
Endovascular, Operative Surgery
and Topographic Anatomy.
Tel.: +7 9038362417,
e-mail: suchkov_med@mail.ru,
Igor A. Suchkov
Information about the authors:
Kalinin Roman E., MD, Professor, Head of the Department of Cardiovascular, Endovascular, Operative Surgery and Topographic Anatomy, Ryazan State Medical University, Ryazan, Russian Federation.
http://orcid.org/0000-0002-0817-9573
Suchkov Igor A., MD, Professor of the Department of Cardiovascular, Endovascular, Operative Surgery and Topographic Anatomy, Ryazan State Medical University, Ryazan, Russian Federation.
http://orcid.org/0000-0002-1292-5452
Egorov Andrey A., PhD, Applicant of the Department of Cardiovascular, Endovascular, Operative Surgery and Topographic Anatomy, Ryazan State Medical University, Ryazan, Russian Federation.
http://orcid.org/0000-0003-0768-7602
Nikiforov Aleksander A., PhD, Associate Professor, Head of the Central Research Laboratory, Ryazan State Medical University, Ryazan, Russian Federation.
http://orcid.org/0000-0003-0866-9705
Mzhavanadze Nina Dzh., PhD, Associate Professor of the Department of Cardiovascular, Endovascular, Operative Surgery and Topographic Anatomy, Ryazan State Medical University, Ryazan, Russian Federation.
http://orcid.org/0000-0001-5437-1112
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