Received September 21, 2007
Accepted on March 17, 2008

ORIGINAL ARTICLES

Novel Links between the Long Pentraxin 3, Endothelial Dysfunction, and Albuminuria in Early and Advanced Chronic Kidney Disease

Mohamed E. Suliman ^*, Mahmut I. Yilmaz ^*, Juan J. Carrero ^*, Abdul Rashid Qureshi ^*, Mutlu Saglam , Osman M. Ipcioglu , Mujdat Yenicesu , Mengli Tong ^*, Olof Heimbürger ^*, Peter Barany ^*, Anders Alvestrand ^*, Bengt Lindholm ^*, and Peter Stenvinkel ^*1

*Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Divisions of Renal Medicine and Baxter Novum, Karolinska University Hospital Huddinge, Stockholm, Sweden; and Departments of Nephrology, Radiology, and Biochemistry, Gülhane School of Medicine, Etlik-Ankara, Turkey

¹ To whom correspondence should be addressed. E-mail: peter.stenvinkel{at}ki.se.

	Abstract

Background and objectives: Albuminuria and inflammation predict cardiovascular events. Pentraxin 3, an inflammatory mediator produced by, among others, endothelial cells, may have a role in atherogenesis.

Design, setting, participants, & measurements: In 207 Swedish patients with stage 5 chronic kidney disease and 79 Turkish patients with type 2 diabetes and proteinuria and normal renal function, whether serum pentraxin 3 levels are associated with albuminuria and endothelial dysfunction was studied.

Results: Patients with stage 5 chronic kidney disease and a high degree of albuminuria more often had diabetes and higher levels of pentraxin 3, vascular cellular adhesion molecule-1, and blood pressure. Moreover, pentraxin 3 was independently associated with 24-h urinary albumin excretion. In patients with type 2 diabetes, pentraxin 3 was significantly higher than in control subjects. Patients with type 2 diabetes and more proteinuria had higher pentraxin 3, C-reactive protein, glycosylated hemoglobin, insulin, and homeostasis model assessment index as well as lower flow-mediated dilation and serum albumin. Pentraxin 3 was positively correlated with C-reactive protein, homeostasis model assessment index, and carotid intima-media thickness and negatively with flow-mediated dilation. Pentraxin 3 and glomerular filtration rate were independently associated with 24-h urinary protein excretion. Only pentraxin 3 and proteinuria were significantly and independently associated with flow-mediated dilation.

Conclusions: In two different renal cohorts, one of stage 5 chronic kidney disease and one of type 2 diabetes and normal renal function, pentraxin 3 was independently associated with proteinuria. Moreover, both pentraxin 3 and proteinuria were associated with endothelial dysfunction in patients with type 2 diabetes.