Abstract: TH-PO347

Controlled Blood Pressure Increases the Appearance of Angiogenic Hemodialysis Patient-Derived Cells In Vitro

Session Information

Category: Acute Kidney Injury

  • 002 AKI: Repair and Regeneration

Authors

  • Huuskes, Brooke M., Monash University, Clayton, Victoria, Australia
  • Debuque, Ryan J, Monash University, Clayton, New South Wales, Australia
  • Polkinghorne, Kevan, Monash Medical Centre and Monash University, Melbourne, Victoria, Australia
  • Kerr, Peter G., Monash Medical Centre and Monash University, Melbourne, Victoria, Australia
  • Samuel, Chrishan S., Monash University, Clayton, Victoria, Australia
  • Ricardo, Sharon D., Monash University, Clayton, Victoria, Australia
Background

Endothelial progenitor cells (EPCs) are present in lower numbers in kidney disease patients who are dialysis-dependent and can be used to predict adverse cardiovascular events. The function of EPCs can be measured using colony forming unit (CFU) assays and the appearance of late outgrowth endothelial cells (OECs) in vitro. Specific clinical parameters can affect EPC function, yet less is known about the relationship between clinical observations and OEC function. Therefore the aim of this study was to determine if the appearance of OECs derived from dialysis-dependent patients was influenced by their clinical history.

Methods

Dialysis-dependent patients (n=20) were recruited to this study; and their age, time on dialysis, blood pressure (BP), erythropoietin (EPO), statin use and smoking status was collected as these parameters have previously demonstrated to affect circulating EPC levels. Blood (10mls) was obtained prior to a single dialysis session and peripheral blood mononuclear cells isolated and cultured. After 7 days CFU was assessed, then cells were further cultured for 21 days or until OECs appeared (identified by cobblestone morphology).

Results

The patient cohort had a mean age of 64.2(±15.5) years and 80% were male. The mean time on hemodialysis was 46 months (±69.6) and blood pressures of 139.1(±27.1)/75.2 (±18.9). Half of the patients received EPO, 30% were administered statins and 65% had a history of or were current smokers. Circulating %EPC of patients receiving EPO was significantly lower then patients who were not (mean diff. 1.487±0.538, 95% CI 0.3-2.7. p=0.0184) and high systolic blood pressure was negatively correlated with %EPC (r=-0.59, p=0.033). We observed a 45% conversion of EPCs to OECs, which was not dependent on starting %EPC (p=0.19). Both systolic (mean diff. 24.95mmHg, 95% CI 1.7-48.1, p=0.0365) and diastolic (mean diff. 18.9, 95%CI 3.2-34.6, p=0.0208) blood pressures were significantly lower in patients when OECs appeared.

Conclusion

BP affects dialysis-dependent patient-derived OEC numbers in culture, suggesting that controlling BP may be key to maintaining vascular health in patients on dialysis.

Funding

  • Government Support - Non-U.S.