Endothelial Dysfunction and Atherosclerosis in Patients With Autosomal Dominant Polycystic Kidney Disease

İskender Ekinci; Mitat Buyukkaba; Ahmet Cinar; Muhammed Tunc; Egemen Cebeci; Meltem Gursu; Rumeyza Kazancioglu

doi:10.7759/cureus.13561

Endothelial Dysfunction and Atherosclerosis in Patients With Autosomal Dominant Polycystic Kidney Disease

Cureus. 2021 Feb 25;13(2):e13561. doi: 10.7759/cureus.13561.

Authors

İskender Ekinci¹, Mitat Buyukkaba², Ahmet Cinar³, Muhammed Tunc⁴, Egemen Cebeci⁵, Meltem Gursu⁴, Rumeyza Kazancioglu⁴

Affiliations

¹ Department of Internal Medicine, SBU Istanbul Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, TUR.
² Department of Internal Medicine, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, TUR.
³ Department of Internal Medicine, Arnavutkoy State Hospital, Istanbul, TUR.
⁴ Department of Nephrology, Bezmialem Foundation University, Istanbul, TUR.
⁵ Department of Nephrology, Haseki Training and Research Hospital, Istanbul, TUR.

Abstract

Introduction In this study, we aimed to determine the endothelial dysfunction (ED) and atherosclerosis in patients with autosomal dominant polycystic kidney disease (ADPKD). Materials and methods This study was conducted with 83 subjects (26 male, mean age: 46±11 years) consisted of three groups including ADPKD, hypertension (HT) and healthy control groups. The groups were evaluated in terms of serum endocan and asymmetric dimethylarginine (ADMA) levels, flow-mediated dilatation (FMD), nitroglycerin-mediated dilation (NMD) and carotid intima-media thickness (CIMT). Results Serum endocan and ADMA levels and CIMT were significantly higher while NMD was significantly lower in ADPKD group than control group. FMD and NMD were lower but serum ADMA level was higher in the ADPKD group than HT group; while serum endocan level and CIMT were not significantly different in ADPKD and HT groups. In ADPKD patients, CIMT value and serum endocan and ADMA levels were higher while NMD was lower in patients with eGFR≤60 mL/min/1.73 m² than patients with eGFR>60 mL/min/1.73 m². Serum ADMA level was higher and NMD was lower in hypertensive ADPKD patients than non-hypertensive ones. Serum endocan level was higher in ADPKD patients with nephrolithiasis and a negative correlation was detected between serum endocan level and 24-hour urine volume. Conclusions Endothelial dysfunction and atherosclerosis are common conditions in ADPKD patients and it was further reinforced in our study. In order to clarify the relationship between serum endocan level and 24-hour urine volume, which is a remarkable finding in our study, larger studies that including the measurement of urine endocan may be useful.

Keywords: asymmetric dimethylarginine; atherosclerosis; autosomal-dominant polycystic kidney disease; carotid intima-media thickness; endocan; endothelial dysfunction; flow mediated dilatation; nitroglycerin mediated dilation.