title: Oxidative stress and endothelial dysfunction in chronic kidney disease.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is characterized by the high prevalence of atherosclerosis. Considering that endothelial dysfunction and oxidative stress are promoters of atherosclerosis, it is of interest to verify whether the two conditions are associated in CKD patients still free of clinical cardiovascular disease (CVD).
  
  
  OBJECTIVE
  To evaluate the association between oxidative stress and endothelial function in end-stage CKD patients without clinically evident CVD.
  
  
  METHODS
  We studied 22 nondiabetic, nonsmoker CKD patients without clinical CVD treated by maintenance hemodialysis and 22 healthy controls. Endothelium- dependent and independent vascular reactivity and oxidative stress, as determined by the plasma levels of thiobarbituric acid-reactive substances--TBARS, were evaluated in all subjects.
  
  
  RESULTS
  Endothelium-dependent (6.0 +/- 4.25 vs. 11.3 +/- 4.46%, p<0.001) and endothelium-independent (11.9 +/- 7.68 vs. 19.1% +/- 6.43%, p<0.001) vascular reactivity were reduced, while TBARS (2.63 +/- 0.51 vs. 1.49 +/- 0.42 nmols/mL) was increased in CKD patients when compared to controls. TBARS levels were significantly related to endothelium-dependent vascular reactivity (r=-0.56, p<0.001) and to systolic blood pressure (r=-0.48, p=0.002).
  
  
  CONCLUSIONS
  Oxidative stress is increased in CKD patients free of CVD and is associated with endothelial dysfunction in patients and controls. The results suggest that oxidative stress and endothelial dysfunction may be involved in the increased susceptibility of CKD patients to CVD and cardiovascular complications.
authors.affiliation: Unidade de Hipertensão, Instituto do Coração, São Paulo, SP, Brasil.
authors.forename: Valeria
authors.initials: V
authors.lastname: Costa-Hong
authors.forename: Luiz Aparecido
authors.initials: LA
authors.lastname: Bortolotto
authors.forename: Vanda
authors.initials: V
authors.lastname: Jorgetti
authors.forename: Fernanda
authors.initials: F
authors.lastname: Consolim-Colombo
authors.forename: Eduardo M
authors.initials: EM
authors.lastname: Krieger
authors.forename: Jose Jayme Galvão de
authors.initials: JJ
authors.lastname: Lima
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000175:diagnosis; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000503:physiopathology*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D018384:Oxidative Stress / Q000502:physiology*; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology*; D017392:Thiobarbituric Acid Reactive Substances / Q000032:analysis; D014664:Vasodilation / Q000502:physiology
chemical_list: D017392:Thiobarbituric Acid Reactive Substances