Abstract: FR-PO189

Biomarkers of Endothelial, Renal, and Platelet Dysfunction in Stage 5 CKD Hemodialysis (CKD5-HD) Patients with Heart Failure (HF)

Session Information

Category: Hypertension

  • 1103 Vascular Biology and Dysfunction

Authors

  • Bansal, Vinod K., Loyola University Medical Center, Maywood, Illinois, United States
  • Mcmillan, Ryan, Loyola University Medical Center, Maywood, Illinois, United States
  • Hoppensteadt, Debra, Loyola University Medical Center, Maywood, Illinois, United States
  • Fareed, Jawed, Loyola University Medical Center, Maywood, Illinois, United States
Background

The aim of this study was to determine the role of endothelial, renal and inflammatory biomarkers in the pathogenesis of heart failure (HF) in patients with stage 5 chronic kidney disease (CKD5-HD) undergoing maintenance hemodialysis (HD).

Methods

Plasma levels of biomarkers: kidney injury molecule-1 (KIM-1), N terminal-pro brain natriuretic peptide (NT-proBNP), glycated hemoglobin (HgA1C), neutrophil gelatinase associated lipocalin (NGAL), interleukin-18 (IL-18), platelet derived growth factor (PDGF), platelet factor 4 (PF4), 25-OH vitamin D, parathyroid hormone (PTH), endothelin and endocan were measured in CKD5-HD patients at the Loyola University Ambulatory Dialysis facility. Normal plasma samples (n=50) were used as control.

Results

The HF (+) CKD5-HD patients, as compared to HF (-) CKD5-HD patients, exhibited significantly elevated NT-proBNP (P = 0.0194) and KIM-1 (P = 0.0485). The NT-proBNP in HF (+) CKD5-HD patients was found to correlate with the levels of serum potassium (P = 0.023 | R = -0.39), calcium (P = 0.029| R = -0.38) and PF4 (P = 0.045 | R = -0.35). The KIM-1 in HF (+) CKD5-HD patients was found to correlate with PTH (P = 0.043 | R = -0.36) and 25-OH vitamin D (P = 0.037 | R = 0.36). In comparison to the normal plasma samples the CKD5-HD patient plasma exhibited varying degrees of elevation in all of the parameters studied.

Conclusion

Elevated plasma NT-proBNP and KIM-1 in CKD5-HD and HF (+) CKD5-HD patients suggest that natriuretic peptides and KIM-1 may contribute to the pathogenesis of HF in CKD5-HD patients. Thus profiling of the biomarkers in CKD5-HD may be helpful in the risk stratification and identifying patients with heart failure.