Turgay Celik1, Mahmut Ilker Yilmaz2, Sevket Balta1, Cengiz Ozturk1, Hilmi Umut Unal2, Mustafa Aparci3, Murat Karaman2, Mustafa Demir1, A Osman Yildirim1, Mutlu Saglam4, Selim Kilic5, Tayfun Eyileten2, İbrahim Aydin6, Atila Iyisoy1. 1. 1 Department of Cardiology, Gulhane School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey. 2. 2 Department of Nephrology, School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey. 3. 3 Department of Cardiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Uskudar-Istanbul, Turkey. 4. 4 Department of Radiology, School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey. 5. 5 Department of Epidemiology, School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey. 6. 6 Department of Clinical Biochemistry, School of Medicine, Gulhane Military Medical Academy, Etlik-Ankara, Turkey.
Abstract
BACKGROUND: Plasma levels of estimated whole blood viscosity (eWBV) have been increased by endothelial inflammation. Because there were no consistent data for assessing the eWBV levels for prediction of cardiovascular event (CVE) in patients with chronic kidney disease (CKD). We aimed to investigate the relationship between plasma eWBV levels and CVEs in patients with CKD. MATERIALS AND METHODS: We conducted a prospective, cross-sectional, long-term follow-up study, assessing the relationship between plasma eWBV levels and CVE (either fatal or nonfatal) in patients with newly diagnosed CKD. We also evaluated estimated glomerular filtration rate (eGFR), pentraxin 3 (PTX3), high-sensitivity C-reactive protein (hsCRP), and flow-mediated dilatation (FMD). RESULTS: Study patients were divided into 2 groups: patients with CVE and patients without CVE. The eWBV levels were higher in patients with CVE. Additionally, PTX3 and hsCRP were higher, and FMD and eGFR were lower in patients with CVE compared to those without CVE. According to the Cox regression analysis, WBV, plasma asymmetric dimethylarginine levels, FMD, hsCRP, eGFR, systolic blood pressure, calcium, and history of diabetes were independent predictors of CVEs in patients with CKD. Kaplan Meier survival curves were generated to establish the impact of the WBV on the cumulative survival of the cohort. Patients with eWBV values higher than 5.2 centipoise (cP) had lower survival rates when compared to patients with eWBV values lower than 5.2 cP (log rank = 4.49 df = 1 P = .034). CONCLUSION: In conclusion, plasma eWBV levels may increase the presence of lower eGFR and affect CVE in patients with CKD independent of classical and unconventional risk factors.
BACKGROUND: Plasma levels of estimated whole blood viscosity (eWBV) have been increased by endothelial inflammation. Because there were no consistent data for assessing the eWBV levels for prediction of cardiovascular event (CVE) in patients with chronic kidney disease (CKD). We aimed to investigate the relationship between plasma eWBV levels and CVEs in patients with CKD. MATERIALS AND METHODS: We conducted a prospective, cross-sectional, long-term follow-up study, assessing the relationship between plasma eWBV levels and CVE (either fatal or nonfatal) in patients with newly diagnosed CKD. We also evaluated estimated glomerular filtration rate (eGFR), pentraxin 3 (PTX3), high-sensitivity C-reactive protein (hsCRP), and flow-mediated dilatation (FMD). RESULTS: Study patients were divided into 2 groups: patients with CVE and patients without CVE. The eWBV levels were higher in patients with CVE. Additionally, PTX3 and hsCRP were higher, and FMD and eGFR were lower in patients with CVE compared to those without CVE. According to the Cox regression analysis, WBV, plasma asymmetric dimethylarginine levels, FMD, hsCRP, eGFR, systolic blood pressure, calcium, and history of diabetes were independent predictors of CVEs in patients with CKD. Kaplan Meier survival curves were generated to establish the impact of the WBV on the cumulative survival of the cohort. Patients with eWBV values higher than 5.2 centipoise (cP) had lower survival rates when compared to patients with eWBV values lower than 5.2 cP (log rank = 4.49 df = 1 P = .034). CONCLUSION: In conclusion, plasma eWBV levels may increase the presence of lower eGFR and affect CVE in patients with CKD independent of classical and unconventional risk factors.
Authors: Peter Korsten; Timothy B Niewold; Michael Zeisberg; Tammy O Utset; Daniel Cho; Lawrence S Zachary; Nadera J Sweiss; Suncica Volkov Journal: Autoimmune Dis Date: 2017-11-29