Oxidative stress and endothelial dysfunction in chronic kidney disease.
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.
Costa-Hong
Valeria
V
Unidade de Hipertensão, Instituto do Coração, São Paulo, SP, Brasil.
Bortolotto
Luiz Aparecido
LA
Jorgetti
Vanda
V
Consolim-Colombo
Fernanda
F
Krieger
Eduardo M
EM
Lima
Jose Jayme Galvão de
JJ
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
D017392:Thiobarbituric Acid Reactive Substances