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Chronic Kidney Disease |
* Department of Nephrology, Department of Internal Medicine, and Department of Radiology, Gülhane School of Medicine, Etlik-Ankara, Turkey; Divisions of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
Correspondence: Dr. Mahmut Ilker Yilmaz, Department of Nephrology, Gulhane School of Medicine, 06018 Etlik-Ankara, Turkey. Phone: +90 312 3044076; Fax: +90 312 3042920; E-mail: mahmutiyilmaz{at}yahoo.com
Background and objectives: Long pentraxin 3 (PTX3) is a multimeric inflammatory mediator. Increased serum PTX3 levels have been reported among end-stage renal disease patients. Moreover, PTX3 has been suggested to represent a novel mortality risk factor, and elevated PTX3 levels have been shown to accompany increased albuminuria among patients with chronic kidney disease (CKD).
Design, setting, participants, & measurements: We analyzed data of 49 persons with stage 1 diabetic CKD and 32 healthy subjects in a prospective controlled trial. Endothelial dysfunction was determined by flow-mediated dilation (FMD). Serum PTX3, high-sensitivity C-reactive protein (hs-CRP) levels, and FMD were studied in baseline and after 12 wk of ramipril therapy. Stepwise multivariate regression analysis evaluated the association of FMD with clinical and serologic parameters.
Results: Serum PTX3, hsCRP, and albumin levels and proteinuria were significantly decreased, and FMD levels were significantly increased, after ramipril treatment. FMD was negatively correlated with serum PTX3, 24-h proteinuria, and hsCRP levels and positively correlated to serum albumin both at baseline and after the 12-wk treatment period. Multivariate regression analysis revealed that PTX3 levels were independently related to FMD both before and after ramipril treatment.
Conclusions: Our study shows that serum PTX3 levels are associated with endothelial dysfunction in patients with stage 1 diabetic CKD, independent of CRP. In addition, short-term ACE-inhibitor treatment significantly improves FMD and normalizes PTX3, hsCRP, and urinary protein excretion. (NCT: The study was registered in clinicaltrials.gov as NCT00674596.)
This article has been cited by other articles:
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  M. I. Yilmaz, J. J. Carrero, J. L. Martin-Ventura, A. Sonmez, M. Saglam, T. Celik, H. Yaman, M. Yenicesu, T. Eyileten, J. A. Moreno, et al. Combined Therapy with Renin-Angiotensin System and Calcium Channel Blockers in Type 2 Diabetic Hypertensive Patients with Proteinuria: Effects on Soluble TWEAK, PTX3, and Flow-Mediated Dilation Clin. J. Am. Soc. Nephrol., July 1, 2010; 5(7): 1174 - 1181. [Abstract] [Full Text] [PDF]
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 M. I. Yilmaz, A. Sonmez, M. Saglam, H. Yaman, T. Cayci, S. Kilic, T. Eyileten, K. Caglar, Y. Oguz, A. Vural, et al. Reduced proteinuria using ramipril in diabetic CKD stage 1 decreases circulating cell death receptor activators concurrently with ADMA. A novel pathophysiological pathway? Nephrol. Dial. Transplant., March 26, 2010; (2010) gfq159v1. [Abstract] [Full Text] [PDF]
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J. J. Carrero and P. Stenvinkel Persistent Inflammation as a Catalyst for Other Risk Factors in Chronic Kidney Disease: A Hypothesis Proposal Clin. J. Am. Soc. Nephrol., December 1, 2009; 4(Supplement_1): S49 - S55. [Abstract] [Full Text] [PDF]
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