| Factors associated with Endothelial Dysfunction
in Hemodialysis Patients |
| Jung Hwa Ryu, M.D.1, Mina Yu, M.D.1 , Dong Ryeol Ryu, M.D.1, Seung Jung Kim, M.D.1, Kyu Bok Choi, M.D.1 , Kyun Il Yoon, M.D.1,Duk Hee Kang, M.D.1, Wook Bum Pyun, M.D.2 and Gil Ja Shin, M.D.2 |
Division of Nephrology1 and Cardiology2
Department of Internal Medicine Ewha Womans University College of Medicine, Seoul |
| 원저 : 혈액투석 환자에서 혈관내피세포 기능이상과
관련된 인자들에 관한 연구 |
| 류정화1·유민아1·류동열1·김승정1·최규복1·윤견일1·강덕희1·편욱범2·신길자2 |
| 이화여자대학교 의과대학 신장내과1, 순환기내과2 |
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| Abstract |
Purpose
: Endothelial dysfunction is an event in the atherosclerotic process usually considered reversible
at its early stage. Early detection, therefor, may improve the prognosis in the cardiovascular disease.
The aim of this study was to investigate the vascular function in hemodialysis (HD) patients and
to explore its relation to other various parameters with a specific emphasis on systemic inflammatory
reaction (SIR), nutritional status and the presence of ischemic heart disease (IHD).
Methods
: Flow-mediated endothelium-dependent vasodilatation (FMD) was measured, using Doppler
sonogram, in 37 stable HD patients, 11 healthy people and 24 hypertensive controls. Nitroglycerineinduced
endothelium-independent vasodilatation (EIV) and peak reaction time (PT) of each FMD and
EIV were also measured.
Results
: FMD in HD patients was decreased compared to healthy group whereas it was comparable
in HD patients and hypertensive control. EIV in HD patients was significantly decreased compared to
healthy and hypertensive controls. PT of each FMD and EIV was significantly delayed in HD patients.
Each FMD and EIV showed a negative correlation with serum hsCRP level, but no significant correlations
of FMD with other parameters were noted. Both FMD and EIV were further decreased in HD
patients with IHD than non-IHD group.
Conclusion
: Our study confirmed a characteristic pattern of vascular dysfunction in HD patients: the
impaired endothelial and smooth muscle function with a delayed reaction time. Importantly, SIR was
one of the important factors determining vascular dysfunction in HD patients. Further studies will be
necessary to define the causative role of SIR on endothelial dysfunction and the effect of inflammationmodulating
therapy. |
| Key Words:
Vascular endothelium-dependent relaxation, C-reactive protein, Inflammation, Hemodialysis |
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