Visfatin versus Flow-Mediated Dilatation as a Marker of Endothelial Dysfunction in Pediatric Renal Transplant Recipients
Keywords:End stage renal disease (ESRD), Children, Endothelial dysfunction (ED), Flow- mediated dilatation (FMD), Renal transplantation (RTx), Visfatin
BACKGROUND: Renal transplantation (RTx) is the treatment of choice for paediatric end-stage renal disease (ESRD). A major cause of morbidity and mortality after RTx is cardiovascular disease. Independent predictors of cardiovascular events were shown to constitute an endothelial dysfunction (ED). This study aims to evaluate Visfatin serum level in comparison to brachial artery flow-mediated dilatation (FMD) as a marker of endothelial dysfunction in paediatric RTx recipients.
METHODS: Visfatin serum level has been evaluated in 30 patients on regular hemodialysis (HD), 36 patients post-RTx and 30 controls as a measure for ED, and has been compared to brachial artery FMD.
RESULTS: Visfatin level in transplant recipients was significantly lower than the hemodialysis group as well as FMD was better in transplant recipients. In spite of marked improvement of FMD and marked reduction of visfatin in post-RTx no direct statistical correlation was found between serum Visfatin level and flow-mediated dilatation.CONCLUSION: Pediatric RTx recipients show lower serum Visfatin level and better FMD than those on regular hemodialysis, reflecting less endothelial dysfunction (ED) and less cardiovascular risk. FMD in kidney transplant recipients tends to be less than normal subjects while visfatin level of the same group is similar to controls. Pediatric RTx appears to have a positive impact on the growth development of children with ESRD.
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Verma S, Anderson TJ. Fundamentals of endothelial function for the clinical cardiologist. Circulation. 2002; 105: 546â€“549. https://doi.org/10.1161/hc0502.104540 PMid:11827916
Pawlak K, Pawlak D, Mysliwiec M. Method of dialysis therapy and selected markers of oxidative stress and endothelial injury in patients with chronic renal failure. Pol Arch Med Wewn. 2005; 113:21â€“26. PMid:16130597
Cross J. Endothelial dysfunction in uraemia. Blood Purif. 2002;20:459â€“461. https://doi.org/10.1159/000063552 PMid:12207092
Foley RN, Murray MA, Li S, Herzog AC, McBean MA, Eggers WP, Collins AJ. Chronic kidney disease and the risk for cardiovascular disease, renal replacement, and death in the United States Medicare population, 1998 to 1999. J Am Soc Nephrol. 2005; 16:489â€“495. https://doi.org/10.1681/ASN.2004030203 PMid:15590763
Kocak H, Ceken K, Yavuz A, et al. Effect of renal transplantation on endothelial function in haemodialysis patients. Nephrol Dial Transplant. 2006; 21: 203â€“207. https://doi.org/10.1093/ndt/gfi119 PMid:16144848
Fukuhara A, Matsuda M, Nishizawa M. Visfatin: a protein secreted by visceral fat that mimics the effects of insulin. Science. 2005;307:426-430. https://doi.org/10.1126/science.1097243 PMid:15604363
Mu J, Feng B, Ye Z, Yuan F, Zeng W. Visfatin is related to lipid dysregulation, endothelial dysfunction and atherosclerosis in patients with chronic kidney disease. J Nephrol. 2010; 24: 177â€“184. https://doi.org/10.5301/JN.2010.3488
Kato A, Odamaki M, Ishida J, Hishida A. Relationship between serum pre-B cell colony enhancing factor/visfatin and atherosclerotic parameters in chronic hemodialysis patients. Am J Nephrol. 2009;29:31-35. https://doi.org/10.1159/000148648 PMid:18663287
Report of the Second Task Force on Blood Pressure Control in Children, Heart, Lung and Blood Institute, Bthesda. Pediatrics. 1987; 79:1-25. Quoted from Bernstein D. History and physical examination. In: Kliegman RM, Stanton BF, Geme JSt, Schor NF, Behrman RE (eds). Nelson Textbook of Pediatrics; 19th edition, 2011:1534-1535.
Schwartz GJ & Gauthier B. A simple estimate of glomular filteration rate in adolescent boys. J Pediatr. 1985; 106: 522âˆ’526. https://doi.org/10.1016/S0022-3476(85)80697-1
Eknoyan G, Beck GJ, Alfred K. et al. Effect of Dialysis Dose and Membrane Flux in Maintenance Hemodialysis for the Hemodialysis (HEMO) Study Group. N Engl J Med. 2002; 347:2010-2019. https://doi.org/10.1056/NEJMoa021583 PMid:12490682
LainÅ¡Äak. Cardiovascular Risk in Chronic Kidney Disease The journal of International Federation of Clinical Chemistry and Laboratory Medicine. 2009 ;72-75.
Rockville. North American Pediatric Renal Transplant Cooperative Study (NAPRTCS), 2010. Annual report. Available from: http://www.naprtcs.org (Accessed on May 27, 2011).
Sinha MD, Kerecuk L, Gilg J, Reid CJ. British Association for Paediatric Nephrology. Systemic arterial hypertension in children following renal transplantation: Prevalence and risk factors. Nephrol Dial Transplant. 2012;27:3359â€“68. https://doi.org/10.1093/ndt/gfr804 PMid:22328733
Lotfy AWM, Mohammed NA, El-Tokhy HM, Attia FA. Serum visfatin in chronic renal failure patients on maintenance hemodialysis: A correlation study. Egyptian J Internal Medicine. 2013; 25(4): 202-208. https://doi.org/10.4103/1110-7782.124982
Yilmaz MI, Saglam M, Carrero JJ, et al. Normalization of endothelial dysfunction following renal transplantation is accompanied by a reduction of circulating visfatin/NAMPT. A novel marker of endothelial damage? Clinical Transplantation. 2009; 23(2):241â€“248. https://doi.org/10.1111/j.1399-0012.2008.00921.x PMid:19402217
Prasad A, Tupas-Habib T, Schenke WH, Mincemoyer R, Panza JA. Acute and chronic angiotensin-1 receptor antagonism reverses endothelial dysfunction in atherosclerosis. Circulation. 2000; 101(20):2349-2354. https://doi.org/10.1161/01.CIR.101.20.2349 PMid:10821809
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