Caspian Journal of Internal Medicine
Babol University of Medical Sciences
Sun, Sep 1, 2024
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Volume 14, Issue 4 (Autumn 2023)
Caspian J Intern Med 2023, 14(4): 668-675 |
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Fallah Arzpeyma S, Ramezanzadeh E, Vakilpour A, Abedi M, Hassanipour S. Endothelial function assessment by flow-mediated dilation of the brachial artery in acute kidney injury and chronic kidney disease. Caspian J Intern Med 2023; 14 (4) :668-675
URL: http://caspjim.com/article-1-3509-en.html
URL: http://caspjim.com/article-1-3509-en.html
Sima Fallah Arzpeyma 
, Elham Ramezanzadeh , Azin Vakilpour , Mohammadsadegh Abedi , Soheil Hassanipour
, Elham Ramezanzadeh , Azin Vakilpour , Mohammadsadegh Abedi , Soheil Hassanipour
Razi Clinic Research Development Center, Guilan University of Medical Sciences, Rasht, Iran , simafallaharzpeyma@gmail.com
Abstract: (793 Views)
Background: Endothelial dysfunction has a significant role in the pathogenesis of cardiovascular events in patients with kidney dysfunction. The present study aimed to compare the level of endothelial dysfunction in patients with chronic kidney disease (CKD) and acute kidney injury (AKI) by brachial artery flow-mediated dilation (FMD) technique. Also, we sought to find whether this non-invasive technique may assist in accurately distinguishing the acute or chronic nature of kidney failure in patients presenting with uremia for the first time.
Methods: Demographic and medical characteristics, and laboratory and renal ultrasonography data of the patients with AKI and CKD were collected and compared with a control group. Brachial artery FMD was measured using a Toshiba aplio 300 device with a 7.5 MHz linear probe.
Results: In a total of 175 patients with a mean (SD) age of 55.96(15.54) years, FMD% was significantly lower in the CKD and AKI patients compared to the control group (Mean±SD: 16.28%±10.52%), 16.28 %±4.35%, and 24.24±5.71, respectively, p<0.001). Among the different causes of AKI, contrast-induced nephropathy (10.78%±1.75%), volume depletion (14.87%±1.22%), and post-renal AKI (15.96%±1.54%) had the lowest levels of FMD. Also, a significant correlation between FMD and eGFR (r=0.26, P<0.001), serum Hb (r=0.18, P=0.013), Na (r=0.19, P=0.011), BUN (r=-0.21, P=0.005) and Cr (r=- 0.13, P=0.084) was reported.
Conclusion: Compared to the control group, CKD and AKI patients showed greater levels of endothelial dysfunction as evidenced by lower brachial artery FMD. However, the FMD technique did not appear to be a practical method in differentiating CKD and AKI in patients presenting with uremia for the first time.
Methods: Demographic and medical characteristics, and laboratory and renal ultrasonography data of the patients with AKI and CKD were collected and compared with a control group. Brachial artery FMD was measured using a Toshiba aplio 300 device with a 7.5 MHz linear probe.
Results: In a total of 175 patients with a mean (SD) age of 55.96(15.54) years, FMD% was significantly lower in the CKD and AKI patients compared to the control group (Mean±SD: 16.28%±10.52%), 16.28 %±4.35%, and 24.24±5.71, respectively, p<0.001). Among the different causes of AKI, contrast-induced nephropathy (10.78%±1.75%), volume depletion (14.87%±1.22%), and post-renal AKI (15.96%±1.54%) had the lowest levels of FMD. Also, a significant correlation between FMD and eGFR (r=0.26, P<0.001), serum Hb (r=0.18, P=0.013), Na (r=0.19, P=0.011), BUN (r=-0.21, P=0.005) and Cr (r=- 0.13, P=0.084) was reported.
Conclusion: Compared to the control group, CKD and AKI patients showed greater levels of endothelial dysfunction as evidenced by lower brachial artery FMD. However, the FMD technique did not appear to be a practical method in differentiating CKD and AKI in patients presenting with uremia for the first time.
Keywords: Acute kidney injury, chronic kidney disease, endothelium, endothelial dysfunction, flow-mediated dilation
Type of Study: Original Article |
Subject:
Nephrology
Received: 2022/06/1 | Accepted: 2022/10/15 | Published: 2023/09/28
Received: 2022/06/1 | Accepted: 2022/10/15 | Published: 2023/09/28
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