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Abstract: FR-PO750

Development of a Microparticle-Based Bio-marker of Hemodialysis Induced Vascular Injury

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Gomes, Janice, University of Western Ontario, Toronto, Ontario, Canada
  • Grant, Claire, Lawson Health Research Institute, London, Ontario, Canada
  • Qirjazi, Elena, University of Western Ontario, Toronto, Ontario, Canada
  • McIntyre, Christopher W., University of Western Ontario, Toronto, Ontario, Canada
Background

Hemodialysis (HD) is a treatment option that is associated with complications such as microvascular dysfunction and damage to vulnerable vascular beds. This damage has been observed through gold standard imaging techniques such as Echo, CT, MRI, and PET, however there are no reliable blood based bio-markers available to identify this injury that might be suitable to use in general clinical practice. We therefore investigated the use of blood vessel and circulating blood cell derived microparticles as an indicator of vascular damage in a cohort of HD patients under standard treatment condition and a state of reduced circulatory stress (using dialysate cooling).

Methods

An assay was created to assess the level of endothelial, platelet, erythrocyte, and leukocyte derived microparticles. By utilizing Nanoscale Flow Cytometry (Apogee A50), we measured microparticle levels within plasma samples obtained from patients receiving standard hemodialysis treatment (36.5 degrees Celsius, n=31) and 16 of the same patients receiving cooled dialysate treatment (35 degrees Celsius). Microparticles were enumerated at pre, during, and post treatment.

Results

CD31+/CD62E+ microparticles (derived from activated endothelium) correlated with ultrafiltration rate (as the primary driver of HD-based circulatory stress) (R2=0.1720, p<0.05). There was no relationship between erythrocyte, leukocyte, and platelet derived microparticles and ultrafiltration rate. Furthermore, we observed that 86% of patients experienced a reduction in CD62E+ (e-selectin) microparticle levels when administered cooled dialysate treatment in comparison to standard treatment (Figure, **p<0.01).

Conclusion

The use of microparticles as a bio-marker of HD induced ischemic injury shows promise and warrants further refinement and investigation to identify and risk assess patients receiving HD, as well as monitoring response to efforts to individualize and optimize HD treatment.