PDF(Pubmed)
Abstract：
Cardiovascular disease is a prevalent complication in patients with end-stage renal disease (ESRD) on maintenance hemodialysis. In the ESRD patient population, cardiovascular mortality is 20 times higher compared to the general population. The strong relationship between both illnesses can be explained through cardiorenal syndrome (CRS). CRS encompasses a spectrum of disorders involving both the heart and kidneys in which acute or chronic dysfunction in one organ may induce a similar effect in the other organ. Current literature reveals that inflammation and thrombosis are integral to CRS development. Hence, this study aims to demonstrate whether thromboinflammatory biomarkers and laboratory parameters correlate with ESRD progression and the development of CRS. Ninety-five ESRD patients were recruited at Loyola University Medical Center hemodialysis unit. Epic chart analysis was used to determine patients with CRS. Biomarkers (C-reactive protein, tumor necrosis factor alpha, interleukin-6, Annexin V, L-fatty acid binding protein, monocyte chemoattractant protein 1, nitric oxide, von Willebrand factor, D-dimer, and plasminogen activator inhibitor-1) were profiled using the enzyme-linked immunosorbent assay method in patients with and without CRS in the ESRD cohort. All biomarkers were significantly elevated in ESRD patients compared to normal controls (P < .05) and laboratory parameters, ferritin (521.99 ± 289.33) and PTH (442.91 ± 1.50). Through EPIC chart analysis 47% of ESRD patients have CRS. D-dimer and TNF-α were significantly elevated in patients with CRS compared to patients without CRS. This study suggests that biomarkers, D-dimer, and TNF-α, can be good predictors of CRS in ESRD patients.
摘要：
心血管疾病是终末期肾病（ESRD）维持性血液透析患者的常见并发症。在ESRD患者人群中，心血管死亡率是普通人群的20倍.两种疾病之间的紧密关系可以通过心肾综合征（CRS）来解释。CRS包括一系列涉及心脏和肾脏的病症,其中一个器官中的急性或慢性功能障碍可以在另一个器官中诱导类似的作用。目前的文献表明，炎症和血栓形成是CRS发展的组成部分。因此，本研究旨在证明血栓炎症生物标志物和实验室参数是否与ESRD进展和CRS的发展相关.在洛约拉大学医学中心血液透析单元招募了95名ESRD患者。使用史诗分析来确定CRS患者。生物标志物(C反应蛋白，肿瘤坏死因子α,白细胞介素-6，膜联蛋白V，L-脂肪酸结合蛋白,单核细胞趋化蛋白1，一氧化氮，vonWillebrand因子,D-二聚体,和纤溶酶原激活物抑制剂-1）使用酶联免疫吸附测定法在ESRD队列中有和没有CRS的患者中进行了分析。与正常对照相比，ESRD患者的所有生物标志物均显着升高（P<0.05）和实验室参数，铁蛋白(521.99±289.33)和PTH(442.91±1.50)。通过EPIC图分析,47%的ESRD患者患有CRS。与无CRS患者相比，有CRS患者的D-二聚体和TNF-α显著升高。这项研究表明，生物标志物，D-二聚体,和TNF-α,可以很好地预测ESRD患者的CRS。
