Inflammation, Endothelial Dysfunction and Increased Left Ventricular Mass in Chronic Kidney Disease (CKD) Patients: A Longitudinal Study

PLoS One. 2015 Sep 23;10(9):e0138461. doi: 10.1371/journal.pone.0138461. eCollection 2015.

Abstract

Introduction: Within this longitudinal study we investigated the association of inflammation markers C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNFα) and endothelial dysfunction markers intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) with left ventricular mass indexed for height(2.71) (LVMI) in hypertensive predialysis CKD patients.

Material and methods: From 2004 to 2005, 182 incident consecutive adult patients from the outpatient CKD clinics of two hospitals in Greece with CKD and hypertension or using antihypertensive medication, were included. Of these, 107 patients underwent CRP (mg/l) and LVMI (g/height(2.71)) measurements annually for three years.

Results: In the longitudinal analyses, using linear mixed modeling, a higher IL-6 (ß = 1.9 (95%ci:0.38;3.5), inflammation score based on CRP, IL-6 and TNF-α (ß = 5.0 (95%ci:0.72; 9.4) and VCAM-1 (ß = 0.01 (95%ci:0.005;0.02) were associated with higher LVMI. These models were adjusted for age, gender and primary renal disease, and for confounders that on top changed the beta with ≥ 10%, i.e. diuretic use (for IL-6 and inflammation score).

Conclusion: The results suggest that in predialysis CKD patients, inflammation as well as endothelial dysfunction may play an important role towards the increase in LVMI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / metabolism
  • Cross-Sectional Studies
  • Endothelium, Vascular / pathology
  • Endothelium, Vascular / physiopathology*
  • Female
  • Heart Ventricles / pathology*
  • Heart Ventricles / physiopathology*
  • Humans
  • Inflammation / complications*
  • Inflammation / pathology*
  • Interleukin-6
  • Linear Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Organ Size
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / physiopathology*
  • Tumor Necrosis Factor-alpha / metabolism
  • Vascular Cell Adhesion Molecule-1 / metabolism

Substances

  • Biomarkers
  • IL6 protein, human
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • Vascular Cell Adhesion Molecule-1

Grant support

The research leading to these results has received funding from the European Community's Seventh Framework Programme under grant agreement number HEALTH-F2-2009-241544 (SysKID). Additionally, this article was written by VSS and KJJ on behalf of the ERA-EDTA Registry which is an official body of the ERA-EDTA (European Renal Association – European Dialysis and Transplant Association). The ERA-EDTA Registry is funded by the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA).