Nemcsik, Janos and Cseprekal, Orsolya and Egresits, Jozsef and Kielstein, Jan and Kuempers, Philipp and Lukasz, Alexander and Tabak, Adam and Marton, Adrienn and Nemeth, Zsofia K. and Jarai, Zoltan and Godina, Gabriella and Sallai, Laszlo and Farkas, Katalin and Kiss, Istvan and Tisler, Andras (2017) The role of laser Doppler flowmetry tests, serum angiopoietin-2, asymmetric and symmetric dimethylarginine to predict outcome in chronic kidney disease. JOURNAL OF HYPERTENSION, 35 (5). pp. 1109-1118. ISSN 0263-6352, 1473-5598
Full text not available from this repository. (Request a copy)Abstract
Objective: The role of biochemical and functional markers of microvascular dysfunction to predict cardiovascular outcomes in nondialyzed chronic kidney disease (CKD) remains unclear. In this prospective cohort study, we assessed whether biochemical [serum level of angiopoietin-2 (Ang-2), asymmetric and symmetric dimethylarginin] and functional (laser Doppler flowmetry) measures of microvascular function predicted cardiovascular events, cardiovascular and all-cause mortality in CKD patients. Methods: Postocclusive reactive hyperemia area (PORHHA), acetylcholine and sodium nitroprusside-mediated flow changes were estimated by laser Doppler flowmetry, and Ang-2, asymmetric and symmetric dimethylarginin were assessed in 105 CKD patients at baseline. Multiple failure time Cox-regression analyses with backward elimination were performed to determine the predictors of the combined endpoint of cardiovascular mortality and cardiovascular events or all-cause mortality and cardiovascular events during a median of 66.6 (interquartile range 39.8-80.4) months of follow-up. Results: In univariate models lnAng-2 and lnPORH(HA) both predicted the cardiovascular outcome besides age, diabetes, baseline cardiovascular disease, brachial pulse pressure and log C-reactive protein. In multivariate analysis lnPORHHA [hazard ratio: 0.66 (95% confidence interval: 0.49-0.89) per ln(mU s)], age [1.03 (1.01-1.06) per year], log C-reactive protein [1.31 (1.06-1.64) per ln(mg/l)] and diabetes [3.33 (1.70-6.53)] remained significant predictors of the cardiovascular outcome, whereas lnAng-2 did not enter the model. Neither of the microvascular variables were an independent predictor of all-cause mortality and cardiovascular events. Conclusion: Among the functional and biochemical microvascular parameters PORHHA seems to improve cardiovascular risk assessment in CKD. Nevertheless the robustness of traditional risk factors seems to outweigh the role of microvascular biomarkers on all-cause mortality and cardiovascular events at this time.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | MICROVASCULAR ENDOTHELIAL FUNCTION; STAGE RENAL-DISEASE; CARDIOVASCULAR-DISEASE; NONINVASIVE ASSESSMENT; HYPERTENSIVE PATIENTS; DIABETES-MELLITUS; HEART-DISEASE; RISK-FACTORS; SKIN; DYSFUNCTION; angiopoietin-2; asymmetric dimethylarginine; chronic kidney disease; laser Doppler flowmetry; prospective cohort study; symmetric dimethylarginine |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Dec 2018 13:10 |
| Last Modified: | 28 Feb 2019 10:31 |
| URI: | https://pred.uni-regensburg.de/id/eprint/954 |
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