title: Endothelial activation markers in anemic non-dialysis chronic kidney disease patients.
abstract: 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.
authors.affiliation: Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Tejas V
authors.initials: TV
authors.lastname: Patel
authors.forename: Bharati V
authors.initials: BV
authors.lastname: Mittal
authors.forename: Sai Ram
authors.initials: SR
authors.lastname: Keithi-Reddy
authors.forename: Jeremy S
authors.initials: JS
authors.lastname: Duffield
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Singh
mesh_terms: 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
chemical_list: D016207:Cytokines; D007155:Immunologic Factors