Endothelial activation markers in anemic non-dialysis chronic kidney disease patients.
OBJECTIVE
Anemia in chronic kidney disease is an independent predictor of cardiovascular disease (CVD). We explored the relationship between anemia and markers of inflammation and endothelial activation in non-dialysis chronic kidney disease (ND-CKD) patients to understand this mechanism.


METHODS
Cross-sectional analysis was performed on 30 adult ND-CKD patients for markers of inflammation and endothelial activation using a multiplexed immunoassay. Data were analyzed according to the anemic status defined by the modified World Health Organization criteria.


RESULTS
Seventeen patients were classified as anemic. Baseline characteristics by anemic status were similar except that anemic patients were older (p = 0.006), had lower estimated glomerular filtration rate (eGFR; p = 0.01) and higher prevalence of CVD (p = 0.02). Compared to non-anemic patients, log-transformed values of fibrinogen (p = 0.012); von Willebrand factor (vWF, p = 0.008), vascular cell adhesion molecule-1 (VCAM-1, p = 0.025) and C-reactive protein (p = 0.043) were elevated in anemic patients. Serum ferritin (p = 0.93) and serum albumin (p = 0.06) were not different. Age and eGFR-adjusted logistic regression analysis showed that anemic patients had increased odds for a composite of higher median values of fibrinogen, vWF and VCAM-1 (p = 0.01, odds ratio 8.1, 95% CI 1.08-111.0).


CONCLUSIONS
We report the association of anemia with elevated markers of endothelial activation in ND-CKD patients. Longitudinal studies are needed to confirm our findings.
Patel
Tejas V
TV
Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Mittal
Bharati V
BV
Keithi-Reddy
Sai Ram
SR
Duffield
Jeremy S
JS
Singh
Ajay K
AK
D000368:Aged; D000740:Anemia / Q000097:blood* / Q000209:etiology*; D016207:Cytokines / Q000097:blood*; D004730:Endothelium, Vascular / Q000378:metabolism*; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000150:complications*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis
D016207:Cytokines; D007155:Immunologic Factors